Cepljenje odraslih v Sloveniji. Prof. dr. Milan Čižman, dr. med. Klinika za infekcijske bolezni in vročinska stanja, UKCL

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1 Cepljenje odraslih v Sloveniji Prof. dr. Milan Čižman, dr. med. Klinika za infekcijske bolezni in vročinska stanja, UKCL

2 Literatura _cepljenja?pi=18&_18_view=item&_18_newsid=2016 &pl= Infektološki simpozij 2012 Adult vaccination in 11 Central European countries - calendars are not just for children. Chlibek R, Anca I, André F, Čižman M, Ivaskeviciene I, Mangarov A, Mészner Z, Perenovska P, Pokorn M, Prymula R, Richter D, Salman N, Šimurka P, Tamm E, Tešović G, Urbancikova I, Zavadska D, Usonis V. Vaccine Feb 21;30: ACIP a3.htm

3 Cepiva za odrasle Poživitveni odmerki za vzdrževanje cepljenja iz otroštva (MMR, dtap) Cepljenje ostarelih (gripa, pnevmokoki, VZV) Cepljenje odraslih z drugimi osnovnimi boleznimi Cepljenje povezanim z delovnim mestom Popotniki Izbruh bolezni Cepljenje skupin z večjim tveganjem za zbolevanje ali prenos

4 Priporočena cepljenja za starostnike 65 let (Maraspin Čarman V, et al. Infektološki simpozij 2012) Cepivo Dajanje Revakcinacija Inaktivirano cepivo proti gripi IM Letno 23-valentno pnevmokokno cepivo* Absorbirano cepivo proti tetanusu/tetanusu in davici IM IM Po 5 letih, če je prvi odmerek v starosti <65 let Po 10 letih ali prej glede na okuženost rane Cepivo proti pasovcu SC Ni podatkov *glede na podatke o imunogenosti je boljše uporabiti PKC 13-valentno in ev. čez 2 meseca 23-valentno PPV (v Sloveniji še ni uradnih priporočil)

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6 Cepljenje odraslih na delovnem mestu Davica, tetanus (SV) Hepatitis B (zdravstveni delavci) Hepatitis A (komunalni delavci) KME Meningokok (zdravstveni delavci, laboranti) MMR Steklina (veterinarji) Tifus (delavci komunale/10 let) Norice Gripa (SV)

7 Poklici v katerih obstaja nevarnost prenosa bolezni in priporočena cepljenja (Mrvič T, Inf. s. 2012) Poklici Zdravstveni delavci, vključno dijaki in študentje zdrav. šol Delavci, ki delajo z živalmi Delavci, ki delajo z otroci Negovalci Delavci v javnih službah (policija, vojska, reševalci) Laboratorijski delavci Delavci, ki delajo v naravi Možna izpostava telesnim tkivom, tekočinam (komunalni delavci, itd.) Priporočena cepljenja hepatitis B, gripa, pertusis, OMR (neimuni), norice (seronegativni) steklina, vročica Q, gripa pertusis, OMR (neimuni), norice (seronegativni) hepatitis B, gripa hepatitis B, gripa, tetanus steklina, polio, tifus, meningokokne okužbe, antraks KME, tetanus hepatitis

8 Cepljenje odraslih Možen prenos na druge osebe Davica Pertusis Hepatitis B Meningokok MMR Norice Gripa

9 Cepljenje odraslih Epidemiološki razlogi Izbruh ošpic, davice, tifus (družinski član nosilec) Hepatitis A KME endemsko območje Polio izbruh

10 Cepljenje odraslih Dejavniki tveganja Meningokok Hepatitis A Hepatitis B Pnevmokok Norice Gripa Hib Di-te ali Di-te-aP vsakih 10 let

11 Dejavniki tveganja Mednarodna potovanja Rumena mrzlica (obvezno) Davica (obvezno) Tetanus (priporočeno) Influenca (priporočeno) Hepatitis A (priporočeno) Hepatitis B (priporočeno) Meningokoki (priporočeno) Polio (priporočeno) Steklina (priporočeno) Tifus (priporočeno) Meningoencefalitis, ki ga prenašajo členonožci

12 Cepljenje oseb z večjim tveganjem Nosečnice (gripa) Narkomani (hepatitis B) Homoseksualci (hepatitis B) Zdravstveno, negovalno, izobraževalno osebje (gripa, hepatitis B, varicella, MMR)

13 Cepljenje proti pnevmokoknim okužbam v Sloveniji MediaId=3166&_5_AutoResize=false&pl= Leto Število cepljenih

14 Cepljenje proti pnevmokoknim okužbam v Sloveniji v letu 2009 po starostnih skupinah Starost/leta Osnovno cepljenje Skupaj Revakcinacija

15 Število cepljenih proti sezonski gripi v letu 2009 v Sloveniji Starost/leta Št. cepljenih % cepljenih Skupaj

16 Število cepljenih proti sezonski gripi v Sloveniji v letu 2002/ /10

17 Cepljenje proti meningokoknim okužbam glede na starost in razlog v letu 2009 Starost/leta Popotniki Izpostavljeno st na del. mestu Epidemiološ ka indikacija Skupaj

18 Cepljenje proti hepatitisu A ( 16 let) v letu odmerek 2. odmerek Skupaj

19 Cepljenje proti noricam v Sloveniji v letu 2009 Starost/leta Medicinska indikacija Drugo Skupaj

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21 Zaključek Cepljenje odraslih v Sloveniji ni obvezno Odrasle cepimo: izpostavitev na delovnem mestu epidemiološka indikacija osebe z večjim tveganjem popotniki Precepljenost proti pnevmokoknim okužbam z konjugiranim ali polisaharidnim cepivom je nizka, proti gripi se jih cepi <10% NOVO: cepijo se lahko odrasli >50 let z PKV

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