Immunisation

12. (1990)

This bulletin reminds staff that life in Australia is associated with a risk of contracting certain dangerous infections and that, for certain occupations, this risk may be higher than for the general population.

Such risks can be reduced by receiving and maintaining the appropriate immunisation before exposure to the disease agent. Vaccinations are available through consultation with a medical officer at the University Health Service (North Road, Phone 249 3598) or with your local doctor.

General Recommendations

• All adults in the Australian community are advised to maintain their immunity to tetanus, diphtheria, polio, measles and mumps.
• All females are advised, additionally, to maintain their immunity to rubella. (Do not undertake rubella vaccination during pregnancy.)
• A hepatitis-B vaccine is available for people who wish it.

Occupation-based Recommendations

In addition to the general recommendations, members of certain occupations are strongly advised to maintain immunity to the agents listed below.

Note 1: Plus other immunisation relevant to the work being undertaken (e.g. rubella, tuberculosis, smallpox, influenza) as recommended by your medical officer.

Note 2: Plus other immunisation relevant to the location of travel or the work being undertaken (e.g. tuberculosis, cholera, typhoid, meningitis, yellow fever, Japanese encephalitis, malaria prophylaxis) as recommended by your medical officer.

The University Secretary has recommended that the relevant Business Offices:

• advertise the availability of immunisations at the University Health Service,
• reimburse the cost of the occupation-based recommendations to relevant staff who undertake such immunisation.

Notes on the Infections

Tetanus:
An acute, often-fatal disease caused by the toxin produced by Clostridium tetani which grows anaerobically at an injury site. Penetrating wounds containing foreign bodies, wounds associated with soil, dirt or manure, and burns are the greatest risk, but tetanus can follow trivial, even unnoticed wounds. Active immunisation is the only certain protection against tetanus. A completed course of vaccinations provides total protection for many years. Booster doses are recommended every 10 years.

Diphtheria:
An acute, infectious disease caused by toxigenic Corynebacterium diphtheriae which primarily affects the upper respiratory tract. The death rate following infection is about 10%. A completed course of vaccination providing total protection for many years. Booster doses are recommended every 10-15 years.

Polio:
An acute illness resulting from the invasion of the gastro-intestinal tract by poliovirus. The infection may lead to paralysis. Polio remains endemic in many developing countries. In Australia the disease occurs as sporadic outbreaks amongst unvaccinated individuals.

Measles:
An acute illness due to a morbillivirus invasion via the respiratory tract. Measles is highly infectious with an incubation period of about 10 days. Measles is often a severe disease with complications of bronchopneumonia (4% of cases), otitis media (2.5%), and encephalitis (0.05%). The latter complication often produces permanent brain damage.

Mumps:
An acute illness caused by infection by a paramyxovirus. Orchitis occurs in 20% of clinical mumps cases in post-pubertal males, but it is usually unilateral and sterility is rare. Another rare complication is nerve deafness.

Rubella:
The rubella virus generally produces only a mild disease in the adult or child, often only causing a transient skin rash. However, the disease during pregnancy may produce serious congenital defects in the unborn baby. Infection during the first trimester is the period of greatest risk for the fetus but there is also a small risk of hearing defects and delayed development following maternal infection up to the 20th week. Rubella is spread by droplet infection and the incubation period is 14-21 days.

Hepatitis-B:
The hepatitis-B virus is endemic world-wide. The infection has a long incubation time (up to 5 months) and exerts chronic and serious effects on the liver, with death rates up to 20%. Hepatitis-B is not easily transmitted; it requires direct transmission from contaminated blood or body fluid to the blood or body fluid of the recipient (e.g. by transfusion of contaminated blood, by use of contaminated syringes, by sexual transmission, or by contact of blood with broken skin).

References

1. National Health and Medical Research Council, Immunisation Procedures
   3rd edition, AGPS, Canberra, 1986
2. Research School of Pacific Studies, Health in the Tropics Revised edition, The Australian National University, March 1990

For further information contact:
OHS Officer, e-mail: OHS.Officer@anu.edu.au