Haemophilus influenzae type B – HiB

The bacteria Haemophilus influenzae type b cause serious infections, especially in infants and young children. Particularly feared are pneumonia and meningitis as well as inflammation of the mucous membranes of the epiglottis and larynx. The bacterium is transmitted through droplet infection.

These diseases are particularly dangerous in infancy and childhood. In the first two to three months of life, infants still have protective antibodies from their mother’s blood. Afterwards, a defenseless interval begins in the still immature child’s immune system. Laryngitis can quickly lead to shock and death through shortness of breath and choking. Meningitis is fatal in one to five percent of cases. One third of survivors suffer from hearing impairment or developmental delay. Children are particularly at risk between the age of three months and five years. Children do not have their own antibodies until the age of six. The infection can also be dangerous in seniors. In addition to meningitis and epiglottis, there are other serious illnesses, such as pneumonia, heart valve and pericarditis, joint and bone inflammation.

Diphtheria

Diphtheria is a highly contagious infectious disease that occurs mainly in childhood and is now only known to a few people. Because it can lead to severe shortness of breath, it was previously referred to as children’s “strangling angel”. Before the introduction of vaccination prophylaxis, thousands of children died of suffocation every year. Many older people who have survived the disease still suffer from the consequences of myocarditis or nerve paralysis. Diphtheria is caused by the bacterium “Corynebacterium diphteriae”. The bacterium forms a tissue-destroying toxin and can enter various organs via the bloodstream and cause damage there.

Hepatitis A

Hepatitis A is a viral infection that is transmitted via contaminated food and drink and via smear infections. The viruses are excreted in the stool of infected persons and thus enter the food chain. Both frozen and fresh fruit and vegetables as well as shellfish such as mussels and oysters and contaminated drinking water are among the most common sources of infection. Hepatitis A was previously also referred to as “infectious jaundice”. At that time, however, the different hepatitis viruses were not yet known. There were also frequent cases of hepatitis A in Germany in the past. Thanks to hygiene measures such as the expansion of sewage systems and clean drinking water, the disease rates declined. Today, hepatitis A is the most common travel sickness. The course of the disease is protracted, but chronic courses as with hepatitis B are not known.

Hepatitis B

Hepatitis B is a viral infection and is still one of the great epidemics of mankind. Hepatitis B pathogens are one hundred times more infectious than HIV. Around 360 million people worldwide are carriers of the hepatitis B pathogen, around 600,000 people die every year as a result of a hepatitis B infection, in Germany alone up to 1,000 people die every year. The mortality rate for infants and small children is particularly high at 25% due to their incompletely developed immune system.

The disease is often acute and heals on its own. However, if it becomes chronic, serious complications are to be feared. These range from permanent liver damage to liver cirrhosis and liver cancer. Most newborns who are infected by their mother during birth develop a chronic course. In 4-year-olds, the risk of chronic progression is around 50 percent and in older adults only around 5 percent. The risk therefore decreases with increasing age.

The first steps towards eradicating hepatitis B have been taken through global vaccination campaigns. Nevertheless, there is still a long way to go before the disease disappears completely. The number of people who excrete the hepatitis B pathogens throughout their lives is too high.

HPV

The human papillomavirus, HPV for short, is a highly variable type of pathogen. More than 120 types of HPV are currently known. Depending on the type, HP viruses cause different infections. These range from simple warts on the hands, feet and face to extremely unpleasant genital warts. Among sexually transmitted diseases, HPV infection is the most common sexually transmitted disease. Unfortunately, in addition to these types, there are also HPV types that can cause malignant cell changes. These so-called high-risk HPVs increase the risk of developing penile and anal cancer in men. In women, they can cause malignant cervical cancer. HPV types can be detected in 70% of cervical tumors. And this even years after the infection!
Almost everyone is infected with HPV in the course of their lives. The virus is usually transmitted through skin contact or sexual intercourse. A smear infection, i.e. transmission through hands or infected objects (e.g. towels, toothbrushes, razors, etc.) cannot be ruled out either.

Condoms do not offer 100% protection, as the areas of skin not covered by the condom can become infected. Sexual practices with an increased risk of injury increase the risk of infection, as the viruses penetrate injured tissue more easily. HPV can also be transmitted to the oral mucosa during oral sex and cause tumors in the mouth and throat. Transmission from HPV-infected mothers to their child during birth is also known.

The best protection against infection and therefore the best long-term protection against a malignant disease is a vaccination. However, regular check-ups are still urgently required.

Influenza

The so-called “real” flu is a highly contagious infectious disease. It is triggered by influenza viruses. Transmission occurs through droplet infection (coughing, sneezing), contaminated surfaces (e.g. door handles) and hand/mouth and hand/nose contact (e.g. when shaking hands). A distinction is made between influenza types A, B and C. Types A and B are particularly important for humans, as only these two can trigger epidemics, while influenza C usually only causes mild illnesses of the upper respiratory tract. The influenza virus has the peculiarity that it can change. This affects both the surface structure (so-called antigen drift) and the genetic information (so-called antigen shift).

Measles

Measles is caused by viruses and leads to a highly contagious disease. Transmission occurs from person to person via air and droplets when speaking, coughing and sneezing. Before the introduction of vaccination in the early 1970s, more than 90% of people fell ill as children. There is no effective treatment, so adequate vaccination is particularly important. The two-pointed course and the measles rash, also known as measles exanthema, are typical. Patients suffer from non-specific cold symptoms for the first few days. After a short recovery of about 3 days, a second rise in temperature follows and at the same time the typical measles exanthema. It spreads from the head over the body to the extremities and is characterized by red spots, some of which are raised and merge in many places. In this second phase, those affected are often seriously ill with a high fever and severe general symptoms. White spots on the oral mucosa (Koplik’s spots) and conjunctivitis are also typical. In 75% of cases, the infection heals without consequences.

A quarter of those who contract the disease go on to suffer complications, some of which are severe. Pneumonia and inflammation of the brain are particularly feared.

Subacute sclerosing panencephalitis (SSPE) is a rare but always fatal complication. SSPE occurs in 1:1000 to 1:5000 cases in children. The younger the children are at the time of infection, the higher the risk. 4-10 years after the measles infection, SSPE leads to neurological changes and deficits, which ultimately lead to death.

Meningococcus

Meningococci are bacteria of the species Neisseria meningititis. Currently, 13 different serogroups are known. The most common and therefore the most important are types A, B, C, W and Y. Meningococci are spread worldwide and are very dangerous. A meningococcal infection can lead to serious complications such as meningitis, tissue necrosis and even death. Vaccinations are now available to protect against the most important types of pathogens.

Mumps

Mumps, also known as goat’s foot, is caused by viruses. A typical feature of this infectious disease is “hamster cheeks” – caused by a very painful inflammation and swelling of the parotid glands. But it doesn’t always stay that way. Mumps can lead to nerve damage in the facial area, meningitis or – in boys after puberty and in men – to inflammation of the testicles with subsequent infertility. Transmission occurs either via air and droplets when speaking, coughing and sneezing, through direct contact or via objects contaminated with saliva. Overall, there has been an age shift towards adolescence and young adulthood in the last 10 years. According to surveys by the RKI, 3 out of 4 patients in 2013 were older than 20 years.

Mumps is found all over the world. Before the introduction of vaccinations, mumps usually occurred in childhood and was around 2000 times more common worldwide than it is today. In Germany, there were up to 160,000 cases per year in the pre-vaccination era, while in the 12 years from 2001 to 2012, fewer than 900 cases were counted.
As there is no specific treatment, adequate vaccination is the only effective prophylaxis.

Pertussis

Pertussis, also known as whooping cough, is a serious infectious disease that often lasts for many weeks (on average around 3-4 months). Due to the spasmodic coughing fits, whooping cough used to be called “whooping cough”. The English also call whooping cough because of the typical breathing noise when inhaling, which resembles a scream (stridor) at the end of the coughing fits. Whooping cough mainly affects infants and children, but adolescents and adults can also contract the disease. Whooping cough is caused by the bacterium “Bordetella pertussis”. It produces a variety of proteins. Some of these proteins are responsible for the bacterium being able to adhere to the nasopharyngeal mucosa. Another part of the proteins forms a toxin, also known as pertussis toxin, which is responsible for the symptoms of whooping cough. The coughing attacks are sometimes severe and those affected feel as if they are suffocating during the coughing fit. The violent attacks can lead to rib fractures. Infants have the highest risk of serious complications. Almost all deaths involve young, unvaccinated infants under 6 months of age.

Pneumococcus

Pneumococci are bacteria that are widespread. They are surrounded by a capsule of sugar compounds (so-called polysaccharides). Such encapsulated bacteria (including meningococci, for example) are difficult for the human immune system to combat. There are over 80 types of pneumococcus, which differ in the various components of the capsule. 23 of these types are responsible for more than 90% of diseases. As one of the most common pathogens for serious infectious diseases, they cause pneumonia, inflammation of the meninges or middle ear or lead to blood poisoning (sepsis). Pneumococci endanger all age groups – but especially infants and young children, the elderly and people with immune deficiencies. According to the WHO, 2 million people worldwide die from pneumococcal infection every year.

Vaccinations are now available to protect against many dangerous types of pneumococcus.

Poliomyelitis

Polio has been around since ancient times, as historical documents prove. It is a viral disease that affects the muscle-controlling nerve cells of the spinal cord and can lead to permanent paralysis and even death. The virus infects humans and, rarely, great apes. There are 3 different serotypes, which are referred to as polio type I, type II or type III. Until the 1950s, thousands of people were infected with polio every year. It was only with the introduction of vaccination prophylaxis that the number of cases fell rapidly. Nowadays, you hardly ever see people suffering from the consequences of poliomyelitis in the western world. But this also carries the risk of forgetting the disease and the vaccination. Political unrest, wars and globalization are contributing to the fact that polio cases are once again occurring more frequently in Europe.

Rotaviren

Rotaviren sind die häufigste Ursache für Durchfall im Kindesalter weltweit. Es erkranken vorwiegend Säuglinge und Kleinkinder in den ersten beiden Lebensjahren. Eine akute Magen-Darm-Infektion, die durch Rotaviren verursacht wurde, unterscheidet sich nicht wesentlich von den meisten anderen „Magen-Darm“-Infektionen. Die Infektion kann fast unbemerkt verlaufen, nur mit leichtem Durchfall, aber auch als schwere behandlungsbedürftige Erkrankung. Bei Säuglingen und Kleinkindern verlaufen Rotaviren in der Regel jedoch schwerer als andere Darmerkrankungen. Der meist plötzlich einsetzende, wässrige Durchfall wird anfangs oft von leicht erhöhter Temperatur und Erbrechen begleitet. In etwa der Hälfte der Fälle kommen Schnupfen oder Husten hinzu, selten ist das Gehirn in Mitleidenschaft gezogen (Enzephalitis). Üblicherweise dauert der Durchfall 5 Tage an, begleitet von Erbrechen über 2 Tage hinweg.

Weil bei einer Rotaviren-Infektion Erbrechen häufig zusammen mit Durchfall auftritt, ist es oft schwer, den Erkrankten rechtzeitig ausreichend mit Flüssigkeit zu versorgen. Säuglinge und Kleinkinder erkranken deshalb an Rotaviren im Durchschnitt schwerer als an anderen Durchfallerkrankungen. Ist der Flüssigkeitsverlust zu groß, droht die Austrocknung und dem Patienten muss im Krankenhaus durch Infusionen Flüssigkeit zugeführt werden.

In Industrieländern mit ihrer guter Ernährungslage und guten medizinischen Versorgung sind schwere Komplikationen oder gar Todesfälle sehr selten. Dennoch ergab eine Studie, dass in Deutschland immerhin etwa die Hälfte aller Kinder bis 5 Jahre mit einer Rotavirus-Infektion im Krankenhaus behandelt werden müssen. Besonders gefährdet im Hinblick auf Austrocknung sind hier Säuglinge.

Weltweit wird die jährliche Anzahl der Todesfälle durch Rotaviren-Infektionen bei Kindern bis zu einem Alter von 5 Jahren auf 440.000 bis 600.000 (je nach Ausgangsdaten) geschätzt. Besonders betroffen sind Säuglinge in Afrika südlich der Sahara sowie auf dem indischen Subkontinent. Nach Plänen der Weltgesundheitsorganisation (WHO) soll die weltweite Verbreitung von Rotaviren-Infektionen in Zukunft besser überwacht werden. Nach einer Rotavirenerkrankung verfügen die Patienten nur über eine Teilimmunität gegen bestimmte Serotypen des Virus. Das bedeutet, dass Kinder – und Erwachsene – tatsächlich mehrfach an Rotaviren-Infektionen erkranken können. Die Folgeerkrankungen verlaufen in aller Regel nicht mehr so schwer wie die Ersterkrankung.

Rotaviren werden über fäkal-orale Schmierinfektion aber auch durch Tröpfcheninfektion übertragen. Sie sind weltweit verbreitet. Bis zum Alter von 3 Jahren haben 90% aller Kinder weltweit mindestens ein Mal eine Rotaviren-Infektion durchgemacht.

Röteln

Bei Röteln handelt es sich um eine Virusinfektion, die lange Zeit als harmlose Kinderkrankheit galt. Bis in den 60-er Jahren gab es u.a. in den USA große Röteln-Epidemien. Die traurige Bilanz: Mehr als 12 Millionen Infizierte und viele schwerwiegende Komplikationen bei Kindern und Erwachsenen. Am stärksten betroffen, waren schwangere Frauen mit als 11.000 Fehlgeburten und über 20.000 schwerste embryonale Fehlbildungen wie Taubheit, Erblindung, Schäden des Herzens, der Knochen und des Gehirns.

Röteln treten weltweit auf. Sie werden durch Tröpfcheninfektion (Sprechen, Niesen, Husten) oder durch Kontakt zu Rachen- und Nasensekret übertragen. Die Gefahr, sich von einer niesenden, an Röteln erkrankten Person anzustecken, beträgt ca. 50%. Hat sich eine Person infiziert, bricht die Krankheit normalerweise innerhalb von zwei bis drei Wochen aus. Große Rötelnepidemien sind nach Einführung der Impfungen nicht mehr aufgetreten.

Tetanus

Tetanus, as it is also known, leads to severe muscle cramps and even death if breathing is affected. Tetanus is one of the most serious infectious diseases of mankind with a very high mortality rate, especially in children and infants. The pathogen is found almost everywhere. That’s what makes it so dangerous. It even hides in soil or road dust and enters our bodies through even the smallest skin lesions. The causative agent of tetanus is the tetanus bacterium, also known as “Clostridium tetani”. The bacterium forms spores and is therefore extremely environmentally resistant. Spores can survive in the soil for decades and are resistant to heat and most disinfectants. When the spores enter the human body through a wound, they awaken from their “dormant state” and transform back into the toxin-producing tetanus bacterium. The tetanus toxin is one of the strongest toxins known to man.

Varicella

Varicella is also known as chickenpox and is considered by many to be an unpleasant but ultimately harmless childhood disease. This is a misconception, as the disease affects every age group and can – in certain cases – lead to serious complications, from malformations in unborn babies to brain inflammation and even death. Varicella carriers are at particular risk of contracting shingles years later. The reason: the pathogen lies dormant in the body’s nerve cells and breaks out as shingles under certain circumstances, for example in the case of immunodeficiency. The chickenpox virus belongs to the herpes virus family. Varicella is very contagious. The risk of infection is almost 100 percent in the immediate vicinity of sick people or in direct contact! Sick people must stay at home for at least 7-10 days during the infection phase. Children in particular who scratch because of the itchy exanthema run the risk of developing a purulent skin infection that requires antibiotic treatment. Brain cells or the lungs can also be affected. Varicella is one of the few causes that can lead to apoplexy (stroke) with hemiplegia in children. The chances of recovery are good, but residual paralysis may remain. An infection with varicella during pregnancy, like rubella, can also cause damage to the unborn child. However, the probability is lower than with rubella. It is around 2 % for an infection between the 5th and 24th week of pregnancy. Skin changes, neurological diseases and malformations of the brain, paralysis and convulsions, eye damage and skeletal anomalies can be the result. In addition, the risk of pneumonia in the mother is increased during pregnancy. These are often severe, in rare cases even fatal.