15. Immunisation Flashcards
Our immunisation schedule
birth: hep B 2mths, 4 mths, 6 mths: - hep B - DTetP - Hib - Polio - pneumococcal conjugate - rotavirus 12 mths - Hib - MMR - meninge C 18mths - MMRV (+ varicella) - DTP booster 4 years - DTP - polio 10-13yrs - hep B - Varicella 12-13 - HPV (3 doses in 1 yr) 10-17 - DTP
Why is the pertussis case load in aus so up and down?
the immunity isn’t lifelong
Characteristics of diphtheria
high fever, sore red throat> may progress to breathing obstruction.
Can also affect smooth muscle/heart and cause arrhythmias
Outcomes of serious pertussis infection
apnoic after coughing bouts> can get hypoxic encephalopathy and end up with permanent brain damage- more at risk if young infant.
What invx if suspicious for pertussis?
nasal swab
serology for pertussis
management for pertussis
supportive - NGT, O2
antibiotics - a macrolide (azithro/clarithromycin), but abx will just reduce infectivity not course of disease unless caught v early
in patient with swelling around eye, unwell, high fever, what do you need to differentiate?
Need to differentiate periorbital from orbital cellulitis:
- eye movements painful
- visual acuity if possible
- scans
How to treat periorbital cellulitis and causes?
Staph aureus, streptococcus, Hib,
> tx with fluclox for strep/staph
if unvaccinated for HIb> 3rd gen cephalosporin
How is polio spread?
faecal oral- it’s an enterovirus
presentation of mumps?
swollen parotid glands, fever, sore, can’t eat/drink
can cause encephalitis
presentation of measles?
febrile, maculopapular rash, red weepy eyes, runny nose, bad cough.
Commonest complication: secondary bacterial infection - otitis media and pneumonia, enceph
Why do we vaccinate for varicella?
immunosuppressed can be fatal - secondary problems cellulitis
only mening vaccine offered?
C - B is only private at the moment
prophylaxis for close contacts of meningococcal patient
rifampicin
percentage needed for herd immunity
90%
