2. Immunity Flashcards
When should immunisations not be given to a child?
- If younger than the schedule
- If acutely unwell with a fever
- If has had an anaphylactic reaction to a previous dose of the vaccine
What vaccinations are given at birth?
-Hep B
-BCG
When should the DTaP/IPV/Hib/Hep B vaccine be given and what diseases do they protect against?
3 times in infancy:
-8 weeks
-12 weeks
-16 weeks
Protects against 6 diseases:
-Diphtheria
-Tetanus
-Pertussis
-Polio
-H. influenzae type B
-Hep B
When should the pneumococcal and MenB vaccines be given and what do they protect against?
3 times in childhood:
-2 months
-4 months
-13 months
Protects against:
-Pneumococcal infections ie pneumonia, septicaemia, meningitis
-Meningococcal group B bacteria
When are rotavirus jabs given?
-2 months and 3 months
-Protects against gastroenteritis
When are Hib/MenC + MenB jabs given?
-MenB = 8 weeks + 16 weeks + 1 year
-Hib/MenC = 12months
When is the MMR vaccine given and who is not eligible for it?
2 occasions:
-13 months
-3 years and 4 months
Should not be given to:
-Immunocompromised children
-Pregnant girls
-Children with an evolving neurological condition
-Severe allergy to egg (seek advice)
When is the DTaP/IPV booster given and what does it protect against?
-3 years and 4 months (‘4-in-1 pre-school’ booster)
-Also given at 14 years (‘3-in-1 teenage’ booster, without whooping cough)
Protects against (‘dirty wounds’):
-Diphtheria
-Tetanus
-Whooping cough
-Polio
When is HPV given?
-Girls aged 12-13, 2 doses at least 6 months apart
-Protects against strains 6, 11, 16, 18
When is the Men ACWY given and to who?
-Aged 14
-University students
-Those travelling to high-risk areas
What causes an allergic reaction (to food)?
-Immediate reaction involves production of (food-specific) IgE antibodies
How do food allergies typically present?
-Diarrhoea +/- blood/mucus
-Vomiting
-Dysphagia (GORD, abdo pain)
-Faltering growth
-Eczema
-Urticaria
-Erythematous rash - particularly peri-oral
-Asthma symptoms (wheeze)
-Anaphylaxis
How does food intolerance differ to food allergy?
-Food intolerance is NOT an immune-mediated response
-Presentations are similar
-Eg lactose intolerance due to lactase insufficiency
What investigations can be done for food allergies?
-Skin prick test
–Drops of diluted allergen placed on skin, skin pierced
–Includes a histamine and sterile water control
–Interpret after 15mins, wheal develops if an allergy is present
–Positive result only useful if positive history, negative good for ruling out
-Radioallergosorbent test / ELISA
–Determines amount of specific IgE that reacts to allergens (food and wasp/bee venom)
–Used if skin prick not suitable eg eczema
–Positive result only useful if positive history, negative good for ruling out
-Skin patch testing
–Used for contact dermatitis
–Patch with 30-40 allergens is placed on back for 48 hours
How can you manage food allergies?
DIETARY:
-Exclude from diet
-Consider food challenge 6-12 months after exclusion
DRUG:
-Regular eg oral sodium cromoglicate, corticosteroids, antihistamines
-Emergency eg IM adrenaline