Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: history of present illness: is the former 750 gm product of an estimated gestational age pregnancy 24 to 26 weeks born to a 30 year old gravida 9, para 6 woman, prenatal screens, blood type b positive, hepatitis b surface rpr nonreactive, rubella status unknown. the pregnancy was notable for uncertain dating with limited prenatal care. the mother presented to hospital on with possible rupture of membranes. she was transferred to the . she was placed on tocolysis and broad spectrum antibiotics. she the infant was born by vaginal delivery. he emerged with good flexion, color and tone. he had some initial gasping respirations but required positive pressure ventilation. he was intubated electively in the delivery room with an endotracheal tube. he was admitted to the neonatal intensive care unit for further management. apgars were 6 at one minute and 7 at five minutes. physical examination: physical examination on admission to the neonatal intensive care unit showed an infant with gestational age assessment consistent with 26 weeks gestation. weight is 750 gm. head circumference is 26 cm. in general this was a preterm male. head, eyes, ears, nose and throat, anterior fontanelle open and level. sutures palpable with minimal separation. significant molding and edema over the left brow which was felt to be the presenting part. eyes, open, positive red reflex bilaterally, palate intact. orally intubated. chest, marked retractions. lungs with poor aeration bilaterally. equal breathsounds. cardiovascular, regular rate and rhythm without murmur, good peripheral pulses. abdomen soft, minimal bowel sounds. thin cord with three vessels. genitourinary, consistent with gestational age, small phallus, smooth scrotum and undescended testes, patent anus. spine, no sacral anomalies. hips stable. limited abduction, question of mild contractures due to the low amniotic fluid. tone and reflexes consistent with gestational age. hospital course: (by systems including pertinent laboratory data) 1. respiratory - required mechanical ventilation. he was also treated with exogenous doses of surfactant for a total of three doses. he quickly developed chronic lung disease and was treated with inhaled beclovent for a total 23 day course. his respiratory status underwent a deterioration at approximately two weeks of life and he required ventilator support with a centermenix oscillating ventilator. his peak mean airway pressure was 14. he was able to be extubated on day of life #30 and remained on continuous positive airway pressure for two months. after two months he had a trial of nasal cannula oxygen but was found to have increased work of breathing and blood gases revealed partial pressure of carbon dioxide in the 80s. continuous positive airway pressure was reinitiated and a pulmonary consult was obtained as the course of lung disease appeared to be plateaued. he underwent elective tracheostomy on . his recovery postoperatively has been uneventful and at the time of discharge he is on 40% inspired oxygen with mist via a tracheostomy collar. his most recent blood gas was on with a ph of 7.43 and a pco2 of 55. at rest, his respirations are 40s to 60s. he is on diuretic therapy for his chronic lung disease. was also treated for apnea of prematurity with caffeine citrate which was discontinued on . he has not had any spontaneous episodes of apnea or bradycardia for the last six weeks of admission. 2. cardiovascular - required treatment for hypotension during the first three days of life with dopamine. he also was treated for a patent ductus arteriosus with indomethacin. he had a total of two courses of indomethacin and echocardiogram performed on showed a closed patent ductus arteriosus. at the time of discharge, has a soft systolic murmur thought to be consistent with peripheral pulmonary artery stenosis. 3. fluids, electrolytes and nutrition - was initially npo and maintained on intravenous fluids. enteral feedings were started on day of life #4 and gradually advanced to full volume. his maximum caloric intake was 150 cc/kg/day of preemie enfamil 32 cal/oz. at the time of discharge he is p.o. ad lib enfamil 24 cal/oz, we limit his fluids to 160 cc/kg/day because of his chronic lung disease. is given potassium chloride supplements to partner with his diuretic therapy. his most recent electrolytes were on with a serum sodium of 140, a potassium of 4.9, chloride 100, total carbon dioxide of 31, calcium 9.8, phosphorus 6.0 and alkaline phosphatase 389. also receives reglan and zantac as reflux treatment for his chronic lung disease. discharge weight is 4.170 kg which is 9 lb 3 oz. length at the time of discharge is 53.5 cm which is also 21 inches and head circumference is 36.5 cm. 4. infectious disease - due to the high suspicion of chorioamnionitis, was evaluated for sepsis at the time of birth. a blood culture was no growth. a lumbar puncture was performed without evidence for meningitis. he empirically received a seven day course of antibiotics for presumed sepsis. he did not have any other episodes of proven sepsis during admission. on infection control surveillance cultures, he was noted to be colonized with vancomycin resistent enterococcus. 5. hematological - is blood type ab positive, his coombs test at the time of birth was negative. he received four transfusions of packed red blood cells during the admission. his last transfusion occurred on . his most recent hematocrit was 32.4% on . 6. gastrointestinal - required treatment for unconjugated hyperbilirubinemia with phototherapy. his peak serum bilirubin was 4.8, total over 0.4 direct on day of life #10. he received a total course of ten days of phototherapy. after placement of a tracheostomy was noted to have frequent and projectile vomiting and abdominal ultrasound was obtained to rule out pyloric stenosis. also had an upper gastrointestinal series, barium swallow performed on which showed narrowing of the esophagus in the area retrograde to his tracheostomy tube. his tracheostomy was replaced with a smaller size and the barium swallow was repeated and found to be normal without evidence of the previously noted narrowing of the esophagus. continues to vomit intermittently one to three times per day. as previously noted, he is treated with reglan and zantac for precautionary measures against reflux as recommended by the pulmonary consult team. 7. metabolic - had four state screens showing elevated c5 oh screens, the metabolism genetics team from was consulted and he had an extensive workup for possible acylcarnitine deficiencies. his metabolic workup included a normal acylglycine profile, normal urinary organic acids and normal carnitine levels. based on those results, the consult concluded that he had falsely elevated c5 oh acycarnutine screen on the newborn screen which did not correlate with any particular disorder of metabolism. he was evaluated by dr. from . their recommendation was they would be happy to be reconsulted if there were any new concerns with from a metabolic standpoint. 8. neurological - had numerous head ultrasounds during admission. his initial head ultrasound on day of life #2 showed lateral ventricles that were generous in size left greater than right but no evidence of intraventricular hemorrhage. this ventricular dilatation persisted in subsequent screens. on , a repeat head ultrasound showed moderately dilated ventricles with marked extraaxial fluid. the neurology service from was consulted and recommended neurological follow up. will be seen in the neonatal clinic at , phone , physician . . passed car seat testing. 9. sensory - passed a hearing screen prior to discharge. two ophthalmologic examinations were performed during admission, the first showed immature vessels to zone 3, repeat eye examination of , showed mature retinas. ophthalmological follow up is recommended at eight months of age. 10. psychosocial - the department of social services was granted custody of on . at that time he was assigned an attorney, , , bedham, phone . he was also assigned a guardian at ad litem who is attorney , , , , phone . the dss social worker is , phone . had a mother claim him and her name is , phone . social worker, while here at was , phone . condition on discharge: good. discharge disposition: home with his mother, . the primary pediatrician is dr. , pediatrics, 56 new driftway, , , . phone , fax . care and recommendations at the time of discharge: 1. tracheostomy with a 3.0 tracheostomy tube with oxygen by tracheostomy collar at 40% with mist. 2. feedings, enfamil 24 cal/oz, p.o. with a maximum of 160 cc/kg/day. 3. medications - diuril 80 mg p.o. b.i.d., potassium chloride elixir 4 meq p.o. b.i.d., poly-vi- 1 cc p.o. q.d., fer-in- 0.35 cc p.o., 25 mg elemental iron per cc dilution, reglan 0.4 mg p.o. t.i.d., ranitidine 8 mg p.o. t.i.d. 4. state newborn screen, as previously mentioned, normal except for the elevated c5 oh levels. 5. immunizations, received his hepatitis b vaccine on and . he received the dtap on and . his hemophilus influenza vaccine was given on and . his injectable polio vaccine on and . pneumococcal 7 conjugate vaccine was given on and . also receives synagis on . 6. immunizations recommended, i. synagis respiratory syncytial virus prophylaxis should be considered from through for infants who meet any of the following three criteria: a. born at less than 32 weeks; b. born between 32 and 35 weeks with plans for daycare during respiratory syncytial virus season, with a smoker in the household or with preschool siblings; or c. with chronic lung disease. we would recommend that receive synagis for his second winter due to his chronic lung disease. influenza immunization should be considered annually in the fall for preterm infants with chronic lung disease once they reach six months of age. before this age the family and other caregivers should be considered for immunization against influenza to protect the infant. follow up appointments: 1. pulmonary medicine at with dr. , phone , appointment scheduled for at 8:30 am. 2. otorhinolaryngology with dr. , phone , appointment scheduled for at 9:45 am. 3. follow up program also at , . infant follow up program will notify the mother to set up an appointment. 4. neonatology clinic at , phone . dr. would like to see one month after discharge, appointment not scheduled as of this point. 5. has also been referred to the early intervention program, through . 6. also appointment with dr. , primary pediatrician, at 9:30 am discharge diagnosis: 1. prematurity at 26 weeks gestation 2. respiratory distress syndrome 3. patent ductus arteriosus 4. suspicion for sepsis, ruled out 5. chronic lung disease 6. apnea of prematurity 7. anemia of prematurity 8. unconjugated hyperbilirubinemia 9. status post tracheostomy 10. cerebroventriculomegaly 11. suspicion for acycarnutine deficiency, ruled out dr., 50-470 dictated by: medquist36 d: 13:57 t: 16:19 job#: 1 1 1 r procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more parenteral infusion of concentrated nutritional substances enteral infusion of concentrated nutritional substances non-invasive mechanical ventilation diagnoses: chronic respiratory disease arising in the perinatal period alkalosis tracheostomy status need for prophylactic vaccination and inoculation against diptheria-tetanus- pertussis with poliomyelitis [dtp + polio] other specified vaccinations against hemophilus influenza, type b [hib] other specified vaccinations against streptococcus pneumoniae [pneumococcus] 

Answer: The patient is high likely exposed to