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Section 1. Active and Passive Immunization
IMMUNIZATION IN SPECIAL CLINICAL CIRCUMSTANCES
Children in Residential Institutions
Children housed in institutions pose special problems for control of certain infectious diseases. Ensuring appropriate immunization is important because of the risk of transmission within the facility and because conditions that led to institutionalization may increase the risk of complications from the disease. All children entering a residential institution should have received recommended immunizations for their age (see Fig 1.1, p 26, and Table 1.7, p 28). If they have not been immunized appropriately, arrangements should be made to administer these immunizations as soon as possible. Staff members should be familiar with standard precautions and procedures for handling contaminated blood and body fluids as well as trauma with bleeding. For residents who acquire potentially transmissible infectious agents while living in an institution, isolation precautions similar to those recommended for hospitalized patients should be followed (see Infection Control for Hospitalized Children, p 153). Specific diseases of concern include the following (see the disease-specific chapters in Section 3 for detailed recommendations).
Measles. Epidemics can occur among susceptible children in institutional settings. Recommendations for managing children in an institutional setting when a case of measles is recognized are as follows: (1)
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