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Disease Prevention for Teens

The teen years are a time of growth that involves experimentation and risk taking. For some teens, the social pressures of trying to fit in can be too much. These years can be even more troubling for teens who are confronted with teenage pregnancy, substance abuse, violence, delinquency, suicide, depression, unintentional injuries and school failure. Parents often walk a tightrope between allowing their teenager to gain some independence and helping them to deal with their feelings during this difficult and challenging time in their lives.
Teenagers recognize that they are developmentally between child and adult. Emerging cognitive abilities and social experiences lead teens to question adult values and experiment with health-risk behaviors. Some behaviors threaten current health, while other behaviors may have long-term health consequences. The changes in cognitive abilities offer an opportunity to help teenagers develop attitudes and lifestyles that can enhance their health and well-being. Teen disease prevention includes maintaining a healthy diet, exercising regularly, preventing injuries, and screening annually for potential health conditions that could adversely affect teenage health.

Immunizations


Teens should receive a trivalent Tdap vaccine booster at the 11–12 year visit if not previously vaccinated within five years. With the exception of the Tdap booster at 11–12 years, routine boosters should be administered every 10 years.
Teenagers should receive a second dose of MMR at 11–12 years of age, unless there is documentation of two vaccinations earlier during childhood. The first vaccination is generally given at 1 year of age. MMR should not be administered to pregnant teens.
Teens, 11–12 years of age, who have not received their second Varivax vaccination as part of a routine childhood schedule and who do not have a reliable history of chickenpox should receive this booster vaccination. The first dose is generally given at 1 year of age.
Most infants complete their immunization series against hepatitis B by their first birthday. If not completed, this should be accomplished by teens 11–12 years of age. Hepatitis A should be given to teens who are traveling or living in countries with high or intermediate hepatitis A virus (HAV), live in communities with high rates of HAV, have chronic liver disease, are injecting drug users, or are males who have sex with males. Complete immunization requires two vaccinations separated by a minimum of six months.
Meningococcal vaccine—All teens 11–12 years of age should receive a onetime only vaccination to prevent meningococcal diseases (meningitis, general body sepsis, etc). Of note, this has become a mandatory vaccination for college.
Female teens should be immunized against human papillomavirus (HPV). HPV is the leading cause of cervical cancer and genital warts. Three vaccinations over a six-month period are necessary for maximum protection.
Annual vaccination against influenza is recommended for all teens.

What are sexually transmitted diseases (STDs)?

Sexually transmitted diseases (STDs) are infections that can be transferred from one person to another through any type of sexual contact. STDs are sometimes referred to as sexually transmitted infections (STIs) since they involve the transmission of a disease-causing organism from one person to another during sexual activity. It is important to realize that sexual contact includes more than just sexual intercourse (vaginal and anal). Sexual contact includes kissing, oral-genital contact, and the use of sexual "toys," such as vibrators. STDs probably have been around for thousands of years, but the most dangerous of these conditions, the acquired immunodeficiency syndrome (AIDS), has only been recognized since 1984.
Many STDs are treatable, but effective cures are lacking for others, such as HIV, HPV, and hepatitis B and C. Even gonorrhea, once easily cured, has become resistant to many of the older traditional antibiotics. Many STDs can be present in, and spread by, people who do not have any symptoms of the condition and have not yet been diagnosed with an STD. Therefore, public awareness and education about these infections and the methods of preventing them is important.
There really is no such thing as "safe" sex. The only truly effective way to prevent STDs is abstinence. Sex in the context of a monogamous relationship wherein neither party is infected with a STD also is considered "safe." Most people think that kissing is a safe activity. Unfortunately, syphilis, herpes, and other infections can be contracted through this relatively simple and apparently harmless act. All other forms of sexual contact carry some risk. Condoms are commonly thought to protect against STDs. Condoms are useful in decreasing the spread of certain infections, such as chlamydia and gonorrhea; however, they do not fully protect against other infections such as genital herpes, genital warts, syphilis, and AIDS. Prevention of the spread of STDs is dependent upon the counseling of at-risk individuals and the early diagnosis and treatment of infections.

What is gonorrhea?

Gonorrhea is a bacterial infection caused by the organism Neisseria gonorrheae that is transmitted by sexual contact. Gonorrhea is one of the oldest known sexually transmitted diseases. It is estimated that over one million women are currently infected with gonorrhea. Among women who are infected, 25-40% also will be infected with chlamydia, another type of bacteria that causes another STD. (Chlamydia infection is discussed later in this article.)
Contrary to popular belief, gonorrhea cannot be transmitted from toilet seats or door handles. The bacterium that causes gonorrhea requires very specific conditions for growth and reproduction. It cannot live outside the body for more than a few seconds or minutes, nor can it live on the skin of the hands, arms, or legs. It survives only on moist surfaces within the body and is found most commonly in the vagina, and, more commonly, the cervix. (The cervix is the end of the uterus that protrudes into the vagina.) It can also live in the tube (urethra) through which urine drains from the bladder. Gonorrhea can even exist in the back of the throat (from oral-genital contact) and in the rectum.

Treatment of gonorrhea

In the past, the treatment of uncomplicated gonorrhea was fairly simple. A single injection of penicillin cured almost every infected person. Unfortunately, there are new strains of gonorrhea that have become resistant to various antibiotics, including penicillin, and are therefore more difficult to treat. Fortunately, gonorrhea can still be treated by other injectable or oral medications. Gonorrheal infections that infect the cervix, rectum, urethra, or throat are usually treated with one 400 mg oral dose of cefixime or an intramuscular injection of 125 mg of ceftriaxone. Alternative antibiotic regimens include: cefpodoxime, one 400 mg oral dose; ciprofloxacin, one 500 mg oral dose; ofloxacin, one 400 mg oral dose; levofloxacin, one oral 250 mg dose; and levofloxacin, one 250 mg oral dose. An intramuscular injection of 2 g of spectinomycin is also an alternative treatment in nonpregnant patients, but this treatment is not effective for throat infections caused by gonorrhea.
Because some developing bacterial strains are resistant to certain antibiotics, ceftriaxone is the recommended treatment for all patients in Hawaii and California and for persons who acquired the infection in certain parts of the world. Treatment should always include medication that will treat chlamydia (such as azithromycin or doxycycline) as well as gonorrhea, because gonorrhea and chlamydia commonly exist together in the same person. The sexual partners of women who have had either gonorrhea or chlamydia must receive treatment for both infections since their partners may be infected as well. Treating the partners also prevents reinfection of the woman.
Women suffering from PID require more aggressive treatment that is effective against the bacteria that cause gonorrhea as well as against other organisms. These women often require intravenous administration of antibiotics. Recommended treatment regimens for PID include.