Infectious Diseases

Immunize routinely

Include patients with IDD in routine immunization programs targeting high-risk populations for influenza and S pneumoniae infections.223, 227

Strongly Recommended

Empirical Ecosystem Expert Experiential

Infectious diseases (eg, influenza, Streptococcus pneumoniae infection, and hepatitis B). People with IDD living in group residential settings are at a higher risk of developing such infections223-225 but have lower rates of immunization and screening compared to those in the general population.226, 227

Offer immunization to those at risk

Offer Hepatitis A and B immunization to all at-risk patients, such as those who require long-term, potentially hepatotoxic medications or who live in group residential settings.225, 228

  Strongly Recommended

Empirical Ecosystem Expert Experiential

Infectious diseases (eg, influenza, Streptococcus pneumoniae infection, and hepatitis B). People with IDD living in group residential settings are at a higher risk of developing such infections223-225 but have lower rates of immunization and screening compared to those in the general population.226, 227

Screen for infectious diseases

Screen patients for infectious diseases according to guidelines for high-risk populations and other special risk factors (eg, group residence, sexual practices, IV drug use).229

  Recommended

Empirical Expert

People with IDD are at a greater risk for developing chronic, invasive, and life-threatening forms of infections because of factors such as increased infectious sources, compromised immunity, inability to report symptoms, and absence of fever and other signs of infection.226, 227 They are also at greater risk of not having these infections detected promptly.

Reduce risk factors for infections

Reduce risk factors for invasive lung infections, such as by supporting safe feeding practices, positioning to enable secretion clearance, and respiratory therapy.226

  Recommended

People with IDD are at a greater risk for developing chronic, invasive and life-threatening forms of infections because of factors such as increased infectious sources, compromised immunity, inability to report symptoms, and absence of fever and other signs of infection.226, 227 They are also at greater risk of not having these infections detected promptly.

Perform a head to toe exam

If a patient manifests changes in behaviour or mental status, perform a head-to-toe examination to detect infection. Alert caregivers to signs and symptoms of infections.

  Recommended

People with IDD are at a greater risk for developing chronic, invasive and life-threatening forms of infections because of factors such as increased infectious sources, compromised immunity, inability to report symptoms, and absence of fever and other signs of infection.226, 227 They are also at greater risk of not having these infections detected promptly.

223. Burton C, Vaudry W, Moore D, Bettinger JA, Tran D, Halperin SA, et al. Burden of seasonal influenza in children with neurodevelopmental conditions. Pediatr Infect Dis J. 2014;33(7):710-4.

224. Smith M, Peacock G, Uyeki TM, Moore C. Influenza vaccination in children with neurologic or neurodevelopmental disorders. Vaccine. 2015.

225. Yen CF, Lin JD. Factors influencing administration of hepatitis B vaccine to community-dwelling teenagers aged 12-18 with an intellectual disability. Res Dev Disabil. 2011;32(6):2943-9.

226. Khasawneh R, Wallen J, Davies HD. Chapter 134: Infectious diseases, immunizations and universal precautions. In: Rubin IL, Merrick J, Greydanus DE, Patel D, editors. Rubin and Crocker 3rd ed. Springer; 2016. p. 1711-28.

227. Wilson B, Jones KB, Weedon D, Bilder D. Care of adults with intellectual and developmental disabilities: Down syndrome. FP Essent. 2015;439:20-5.

228. Public Health Agency of Canada. Canadian immunization guide: Part 3 vaccination of specific populations Public Health Agency of Canada. 2016. Accessed 2016 Nov 6.

229. Severtson SG, Hedden SL, Martins SS, Latimer WW. Patterns of cognitive impairments among heroin and cocaine users: The association with self-reported learning disabilities and infectious disease. J Learn Disabil. 2012;45(2):139-50.

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