CDC - Prevnar13* and Pneumovax* (PSSV23) Recommendations Update

This message serves to inform you about the new ACIP recommendations to give PCV13 (Prevnar 13) to high-risk adults and includes reviews on existing PPSV23 (Pneumovax) recommendations for adults.

This overview is a must-see for every doctor, nurse, and health care provider who provides medical care to adults.

Healthcare providers should follow these overarching recommendations:

• Adults 19 years of age or older with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first followed by a dose of PPSV23 at least 8 weeks later. Subsequent doses of PPSV23 should follow current PPSV23 recommendations for high risk adults.
• Adults 19 years of age or older with the aforementioned conditions (functional or anatomic asplenia, immunocompromising conditions, or those with CSF leaks or cochlear implants) who have previously received one or more doses of PPSV23 should be given a dose of PCV13 one or more years after the last PPSV23 dose was received. For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years since the most recent dose of PPSV23.
• Those who received one or more doses of PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years or older if at least 5 years have elapsed since their previous PPSV23 dose. If a dose of PPSV23 was received at age 65 years or later, no additional doses of PPSV23 are recommended.
• PPSV23 recommendations remain the same for those 65 years and older and those who are immunocompetent with chronic medical conditions, such as diabetes or heart disease.

Source

To learn more about pneumococcal disease and vaccines, visit the resources listed below.

Web Sites

• Pneumococcal vaccine resources
• Recommendations, scenarios and Q&As for health care professionals about PCV13 for immunocompromised adults
• Table: Medical conditions or other indications for administration of PCV13, and indications for PPSV23 administration and revaccination for adults 19 years of age or older

Parenting Common Questions - Breastfeeding during abortion using Misoprostol

Q: I conceived accidentally while my baby is 6 months and being breastfed. I have been advised Misoprostol for abortion. Should I stop Breastfeeding, and for how long?
Ans. Mispoprostol is a prostaglandin E1 analogue. Prostaglandin E1 and other prostaglandins appear normally in colostrum and milk. Misoprostol is rapidly metabolized in the mother to misoprostol acid which is biologically active and is excreted in human breast milk in small quantities. There are no published reports of adverse effects of misoprostol in breast-feeding infants of mothers taking misoprostol. Pharmacokinetic studies reveal that misoprostol is excreted into breast milk with drug levels that rise and fall very quickly. Levels become undetectable within 5 hours of maternal ingestion.¹ However, breastfeeding women should be advised that misoprostol may cause infant diarrhea.² The manufacturer recommends that caution should be exercised when misoprostol is administered to a nursing woman. 
However, because of the low levels of misoprostol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.
Given these facts, my recommendation would be to avoid BF for not more than a day after taking Misoprostol, you may give formula milk during this period.
References
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760893/
http://www.drugs.com/breastfeeding/misoprostol.html

Common Parenting FAQs - Can I breastfeed my baby during the time I have Viral Fever?

Dr. Can i breastfeed my during viral fever i m very scared to feed him?
Yes you can, 

It's actually good for the baby, since the antibodies that protect the child can travel through the Breast milk and help ward off infections,

Warm regards

Dr Gaurav Gupta