Post by Trevor on Oct 4, 2011 12:02:10 GMT
Posted by Charlotte, Oxford on 4/10/2011, 11:24:02, in reply to "Immunisations"
This is certainly 'best practice' though other coeliacs may have to ask. Obviously the risk to individual coeliacs varies and is affected by age and other health issues but it is not always possible to know in advance if, for example, you have a poorly functioning spleen. These vaccines clearly reduce the risk of disease and serious complications and coeliacs would be advised to take them up.
Refs:
www.nhs.uk/Conditions/Coeliac-disease/Pages/Treatment.aspx
Vaccinations
If you have coeliac disease, it can cause your spleen (a small an organ behind the stomach) to work less effectively, making you more vulnerable to infection from certain germs.
Therefore, you may need to have several vaccinations, including:
flu (influenza) jab
HIB/MenC vaccine, which protects against sepsis (blood poisoning), pneumonia (an infection of the tissue of the lungs) and meningitis (an infection of the lining of the brain)
pneumococcal vaccine, which protects against infections caused by the Streptococcus pneumoniae bacterium
www.patient.co.uk/health/Coeliac-Disease.htm
Having coeliac disease can cause your spleen to work less effectively, making you more vulnerable to infection from certain germs. You may therefore need to have several immunisations including:
The flu (influenza) jab.
The Hib vaccine - which protects against blood poisoning, pneumonia, and Hib meningitis.
The pneumococcal vaccine - which protects against infections caused by the bacterium Streptococcus pneumoniae.
www.patient.co.uk/doctor/Pneumococcal-Vaccine.htm
Pneumococcal vaccination schedule
A single dose of 23 polyvalent vaccine, with no repeat vaccination, is normally all that is required for individuals over the age of 5, with the following exceptions:
Patients with no spleen
Patients with splenic dysfunction
Patients with renal disease including nephrotic syndrome
Antibody levels are more likely to decline rapidly in these individuals and they should receive further vaccinations at 5-yearly intervals. Routine checks of antibody levels prior to revaccination in these individuals is not required.3
www.nature.com/ajg/journal/v106/n5/full/ajg2010506a.html
The American Journal of Gastroenterology 106, 933-939 (May 2011) | doi:10.1038/ajg.2010.506
Causes of Death in People With Celiac Disease Spanning the Pre- and Post-Serology Era: A Population-Based Cohort Study From Derby, UK
Matthew J Grainge, Joe West, Timothy R Card and Geoffrey K T Holmes
Abstract
OBJECTIVES:
The objective of the study was to compare cause-specific mortality risks in the periods before and after the introduction of accurate and specific serological tests for diagnosing celiac disease.
METHODS:
This was a prospective cohort study of people with celiac disease diagnosed in Southern Derbyshire, United Kingdom, from the late 1950s onward, and followed-up from 1978 until death or 31 December 2006. Standardized mortality ratios (SMRs) were calculated for all-cause mortality and various cause-specific groups concentrating on the period commencing 2 years after diagnosis of celiac disease.
RESULTS:
A total of 1,092 celiac patients (of whom 90% were incident) contributed 10,152 person-years of follow-up beyond 2 years of diagnosis and 142 deaths. A statistically significant increase in all-cause mortality was observed (SMR 1.37; 95% confidence interval (CI) 1.16–1.62), along with an increase in deaths from cancer (SMR 1.61; 95% CI 1.19–2.13), digestive disease (SMR 2.19; 10 deaths, 4 due to liver disease), and respiratory disease (SMR 1.57; 21 deaths, 11 due to pneumonia). The overall increase in mortality risk was higher for males (SMR 1.86; 95% CI 1.45–2.34) than it was for females (SMR 1.10; 95% CI 0.86–1.38). When results were stratified by period of diagnosis (pre-1990, 1990–1999, and 2000 onward), we found no evidence of differing all-cause mortality between cases diagnosed within these periods.
CONCLUSIONS:
Mortality in people with celiac disease has not materially changed over the 25 years of this study with the introduction of serological tests to aid diagnosis. The excess overall mortality we observed was partly explained by deaths from cancer, digestive disease, and respiratory diseases, of which the majority were deaths from pneumonia, supporting existing guidelines that advise pneumococcal vaccination for celiac patients.
www.ncbi.nlm.nih.gov/pubmed/18679063
Eur J Gastroenterol Hepatol. 2008 Jul;20(7):624-8.
Pneumococcal infection in patients with coeliac disease. Thomas HJ, Wotton CJ, Yeates D, Ahmad T, Jewell DP, Goldacre MJ.
Source Gastroenterology Unit, Radcliffe Infirmary, Oxford, UK. harry.thomas@doctors.org.uk
Abstract
OBJECTIVES:
Some patients with coeliac disease are hyposplenic. Splenectomy is a risk factor for pneumococcal infection. Our objective was to determine the risk of invasive pneumococcal disease - septicaemia, pneumonia or meningitis - in patients with coeliac disease.
....CONCLUSION:
Some patients with coeliac disease have an elevated risk of invasive pneumococcal disease.
www.ncbi.nlm.nih.gov/pubmed/18270242
Gut. 2008 Aug;57(8):1074-80. Epub 2008 Feb 12.
Coeliac disease and risk of sepsis.
Ludvigsson JF, Olén O, Bell M, Ekbom A, Montgomery SM.
Source Department of Paediatrics, Orebro University Hospital, Sweden.
Abstract
OBJECTIVE:
To examine the risk of subsequent sepsis in individuals with coeliac disease.
....CONCLUSION:
This study showed a modestly increased risk of sepsis in patients with coeliac disease with the highest risk for pneumococcal sepsis. This risk increase was limited to those with coeliac disease diagnosed in adulthood. Potential explanations include hyposplenism, increased mucosal permeability and an altered composition of the intestinal glycocalyx in individuals with coeliac disease.
www.medscape.com/viewarticle/413379
Should the Pneumococcal Vaccine Be Repeated in Elderly Patients?
This is certainly 'best practice' though other coeliacs may have to ask. Obviously the risk to individual coeliacs varies and is affected by age and other health issues but it is not always possible to know in advance if, for example, you have a poorly functioning spleen. These vaccines clearly reduce the risk of disease and serious complications and coeliacs would be advised to take them up.
Refs:
www.nhs.uk/Conditions/Coeliac-disease/Pages/Treatment.aspx
Vaccinations
If you have coeliac disease, it can cause your spleen (a small an organ behind the stomach) to work less effectively, making you more vulnerable to infection from certain germs.
Therefore, you may need to have several vaccinations, including:
flu (influenza) jab
HIB/MenC vaccine, which protects against sepsis (blood poisoning), pneumonia (an infection of the tissue of the lungs) and meningitis (an infection of the lining of the brain)
pneumococcal vaccine, which protects against infections caused by the Streptococcus pneumoniae bacterium
www.patient.co.uk/health/Coeliac-Disease.htm
Having coeliac disease can cause your spleen to work less effectively, making you more vulnerable to infection from certain germs. You may therefore need to have several immunisations including:
The flu (influenza) jab.
The Hib vaccine - which protects against blood poisoning, pneumonia, and Hib meningitis.
The pneumococcal vaccine - which protects against infections caused by the bacterium Streptococcus pneumoniae.
www.patient.co.uk/doctor/Pneumococcal-Vaccine.htm
Pneumococcal vaccination schedule
A single dose of 23 polyvalent vaccine, with no repeat vaccination, is normally all that is required for individuals over the age of 5, with the following exceptions:
Patients with no spleen
Patients with splenic dysfunction
Patients with renal disease including nephrotic syndrome
Antibody levels are more likely to decline rapidly in these individuals and they should receive further vaccinations at 5-yearly intervals. Routine checks of antibody levels prior to revaccination in these individuals is not required.3
www.nature.com/ajg/journal/v106/n5/full/ajg2010506a.html
The American Journal of Gastroenterology 106, 933-939 (May 2011) | doi:10.1038/ajg.2010.506
Causes of Death in People With Celiac Disease Spanning the Pre- and Post-Serology Era: A Population-Based Cohort Study From Derby, UK
Matthew J Grainge, Joe West, Timothy R Card and Geoffrey K T Holmes
Abstract
OBJECTIVES:
The objective of the study was to compare cause-specific mortality risks in the periods before and after the introduction of accurate and specific serological tests for diagnosing celiac disease.
METHODS:
This was a prospective cohort study of people with celiac disease diagnosed in Southern Derbyshire, United Kingdom, from the late 1950s onward, and followed-up from 1978 until death or 31 December 2006. Standardized mortality ratios (SMRs) were calculated for all-cause mortality and various cause-specific groups concentrating on the period commencing 2 years after diagnosis of celiac disease.
RESULTS:
A total of 1,092 celiac patients (of whom 90% were incident) contributed 10,152 person-years of follow-up beyond 2 years of diagnosis and 142 deaths. A statistically significant increase in all-cause mortality was observed (SMR 1.37; 95% confidence interval (CI) 1.16–1.62), along with an increase in deaths from cancer (SMR 1.61; 95% CI 1.19–2.13), digestive disease (SMR 2.19; 10 deaths, 4 due to liver disease), and respiratory disease (SMR 1.57; 21 deaths, 11 due to pneumonia). The overall increase in mortality risk was higher for males (SMR 1.86; 95% CI 1.45–2.34) than it was for females (SMR 1.10; 95% CI 0.86–1.38). When results were stratified by period of diagnosis (pre-1990, 1990–1999, and 2000 onward), we found no evidence of differing all-cause mortality between cases diagnosed within these periods.
CONCLUSIONS:
Mortality in people with celiac disease has not materially changed over the 25 years of this study with the introduction of serological tests to aid diagnosis. The excess overall mortality we observed was partly explained by deaths from cancer, digestive disease, and respiratory diseases, of which the majority were deaths from pneumonia, supporting existing guidelines that advise pneumococcal vaccination for celiac patients.
www.ncbi.nlm.nih.gov/pubmed/18679063
Eur J Gastroenterol Hepatol. 2008 Jul;20(7):624-8.
Pneumococcal infection in patients with coeliac disease. Thomas HJ, Wotton CJ, Yeates D, Ahmad T, Jewell DP, Goldacre MJ.
Source Gastroenterology Unit, Radcliffe Infirmary, Oxford, UK. harry.thomas@doctors.org.uk
Abstract
OBJECTIVES:
Some patients with coeliac disease are hyposplenic. Splenectomy is a risk factor for pneumococcal infection. Our objective was to determine the risk of invasive pneumococcal disease - septicaemia, pneumonia or meningitis - in patients with coeliac disease.
....CONCLUSION:
Some patients with coeliac disease have an elevated risk of invasive pneumococcal disease.
www.ncbi.nlm.nih.gov/pubmed/18270242
Gut. 2008 Aug;57(8):1074-80. Epub 2008 Feb 12.
Coeliac disease and risk of sepsis.
Ludvigsson JF, Olén O, Bell M, Ekbom A, Montgomery SM.
Source Department of Paediatrics, Orebro University Hospital, Sweden.
Abstract
OBJECTIVE:
To examine the risk of subsequent sepsis in individuals with coeliac disease.
....CONCLUSION:
This study showed a modestly increased risk of sepsis in patients with coeliac disease with the highest risk for pneumococcal sepsis. This risk increase was limited to those with coeliac disease diagnosed in adulthood. Potential explanations include hyposplenism, increased mucosal permeability and an altered composition of the intestinal glycocalyx in individuals with coeliac disease.
www.medscape.com/viewarticle/413379
Should the Pneumococcal Vaccine Be Repeated in Elderly Patients?