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4540 Community and Population Health > Class 8 Population Health & Vaccine Preventable Disease > Flashcards

Class 8 Population Health & Vaccine Preventable Disease Flashcards

1
Q

WHEN DO YOU INITIATE IMMUNIZATION?

A

Passive immunity from mother is lost
Communicable diseases are a real risk to the infant
Immune system capable of an adequate response
What about prematurity???

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2
Q

Condition that significantly
increases the chance that a serious adverse event will occur if the vaccine is given

A

Contraindication

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3
Q

What are a vaccine considerations

A

Contraindications - Condition that significantly
increases the chance that a serious adverse event will occur if the vaccine is given
 Anaphylaxis to a component of the vaccine
 Significant immunosuppression (live vaccines only)
 Pregnancy (live vaccines only)
 Vaccine ingredient specific contraindications need to be
reviewed in advance

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4
Q

What is a strong contraindicator

A

Anaphylaxis to a component in the vaccine

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5
Q

Signs:
Sneezing, coughing
• Itchiness
• “pins & needles”
• Flushing
• Facial edema • Hives • Respiratory difficulties • Shock/collapse • Anxiety

A

Anaphylactic Shock

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6
Q

Signs:
Pallor  Slow pulse  Saliva  Nausea  Vomiting  Sweating

A

Syncopal Episode

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7
Q

What are ways to promote quality of immunization

A

Administration of vaccination
 Drawing & administering
 Safe disposal of vaccines & needles
 Waiting period post-vaccination

Documentation
 Individual/population
 AEFI (reporting mechanism)

Maintaining Proper Storage Conditions
 Maintaining the cold
chain/Fridges/Transporting

Provincial Registry – PHIMS

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8
Q

Mode of Transmission
— Direct Contact, Indirect Contact

Incubation
— 2-5 days

Communicability
— Untreated - 2 weeks to several months
— Treated – 2 to 4 weeks

Reservoir
—Human Carriers

Clinical Presentation – Greyish spots on
tonsils, sore throat, enlarged lymph nodes, swelling & edema of the neck

Complications – Damage to heart muscle,breathing problems, paralysis
— 1 in 10 die (5-10%) case fatality rate

Control measures — Immunization, Antibiotics,
Isolation and disinfection of contact article

(((Do not have to know/memorize)***

A

DIPHTHERIA

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9
Q

*do mot memorize

Reservoir
– Human Carriers, children & infants are more affected

Clinical Presentation – fever, sore throat, muscle
syndrome, aches, drowsiness, headache, N & V, stiffness of the neck and back with or without flaccid paralysis, muscle aches
— 90% asymptomatic
— 4 – 8% minor illness for a few days
— 1 – 5% viral meningitis
— 1% flaccid paralysis

Complications – paralysis, death, post-___

Control measures - Vaccination, Isolation & Disinfection of contact articles

Global Goal - Eradication of polio
Eradicated in Western Hemisphere in 1994 but not Worldwide

A

POLIOMYELITIS

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10
Q

Mode of Transmission — Direct contact with respiratory
secretions

Incubation
• 6-20 days, usually 7-10 days

Communicability
• To 3 weeks after onset of paroxysmal cough if not treated

Reservoir – Humans

Clinical presentation - begins with low grade fever, runny nose, mild cough (7-10 days) & progresses to violent coughing & whooping which lasts up to 10 weeks

Complications – apnea, seizures, pneumonia
 1-3 deaths in Canada yearly
 1/400 deaths in infancy
 82 cases in 2004 in MB

Control measures – Immunization, exclusion 5 days after tx with antibiotics, tx of close contacts

A

PERTUSSIS

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11
Q

Mode of Transmission
• Bacterial spores through contaminated
puncture wounds, burns, cuts

Incubation
• 3-21 days, average 10

Communicability
• Not transmitted person to person

Reservoir –Soil or fomites contaminated with
soil/feces

Clinical presentation – muscle rigidity & spasm, lockjaw, respiratory & laryngeal spasm

Complications – bone fractures,
— Case fatality rate range from 10 - 90%

Control measures – Immunization, TIG(immunoglob) & wound care

A

TETANUS

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12
Q

Organism: Bacteria
• . influenza type B (Hib) several types

Mode of Transmission
• Droplet infection
• Sneezing & coughing

Incubation
• 2-4 days

Communicability
• 1 week prior to illness & until treated

Reservoir – humans

Clinical presentation – sudden onset, fever, vomiting , lethargy, meningeal irritation

Complications –
 Neurological sequelae (10-15%)
 Deafness (15-20%)
 Case fatality rate 5%

Control measures – Immunization & antibiotic prophylaxis

A

HAEMOPHILUS INFLUENZAE DISEASE

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13
Q

*do not memorize

Organism: bacteria

Mode of Transmission
• Direct contact with respiratory droplets
• 25% carriers

Incubation
• 2-10 days

Communicability
• 7 days prior to symptoms until 24 hours of effective therapy

Reservoir – humans

Clinical presentation – sudden onset, fever, vomiting , stiff neck, rash

Complications
 Hearing loss
 Amputations
 Case fatality rate 15%

Control measures – Immunization & antibiotic
prophylaxis

A

MENINGOCOCCAL (TYPE C)

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14
Q

*do not memorize

Virus

Mode of Transmission
— Droplet
— Direct contact with saliva

Incubation
— 14 – 25 days

Communicability
—2 days before onset of symptoms up to 4 days after

Symptoms
 Swelling of salivary glands (usually parotid), fever, aches
 Sometimes asymptomatic in children

Complications
 Encephalitis (1-2/10,000 cases), Deafness
 Orchitis (20 -30% of postpubertal males), Sterility rare

Case fatality ~ 1/10,000 cases

Cases in Canada/Yr
 1950s: 34,000
 2004: 32

Source: Canadian Immunization Guide

A

MUMPS

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15
Q

Mode of Transmission
 Airborne by Droplet Spread
 Direct contact with infected nasal or throat
secretions

Incubation
 7 -18 days

Communicability
 ½ day before onset of symptoms to 4 days after
appearance of rash

Clinical Presentation – fever, conjunctivitis,
cough, rash beginning on face & body

Complications –
 Otitis media
 Pneumonia
 Encephalitis 1:1000 cases
 Complications more common in infants and
adults

Case fatality rate: 2-3/1000 cases
 Can be up to 30% in developing countries

A

MEASLES

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16
Q

Mode of Transmission
 Direct Droplet
 Congenital via placenta

Incubation
 14 - 21 days

Communicability
 7 days before to 4 days after onset of rash

Control Measures – Avoid contact with pregnant women, exclude
from school

Clinical Presentation – fever, rash, joint pain, lymphademopathy, conjunctivitis

Complications – Congenital _____ Syndrome ()
◦ Cataracts, glaucoma, blindness, deafness,
◦ Malformations
◦ Cardiac Problems, Diabetes, Hypothyroidism, Hepatitis
◦ Chronic Pneumonia
◦ CNS defects, Encephalitis

Cases in Canada/Year
◦ 1971 - 1982: 5,300
◦ 1998 - 2004: 30
◦ Most cases now occur amongst populations who refuse immunization - *No cases
CRS since 2006

17
Q

Mode of Transmission
 Direct Contact
 Airborne
 Household transmission amongst susceptible contact high

Incubation
 10 - 21 days

Communicability
 2 - 5 days before onset of rash and until skin lesions have crusted

Clinical Presentation – slight fever, maculopapular rash in trunk, face, scalp, mucous membrane of mouth then changed to vesicular for 3-4 days, lesions occur in successive crops

Complications –
◦ Viral or bacterial Pneumonia
◦ Hemorrhagic complications
◦ Encephalitis
◦ Congenital Varicella Syndrome

Children with acute leukemia at greatest risk for
complications

Control Measures – Exclude from childcare, work, etc.
Avoid contact with immunosuppressed persons,
Immunoglobulin for close contacts

A

VARICELLA (CHICKEN POX)

18
Q

Organism:
 Virus…several serotypes
 10% to 40% of all childhood gi illness

Mode of Transmission
 Fecal oral

Incubation
• 18 hours – 3 days

Communicability
 Viral shedding few days before onset of illness
& up to 21 days after onset of symptoms

Reservoir – humans

Clinical presentation –
 Acute onset fever & vomiting followed by 5-7 days diarrhea

Complications
 36% of cases see a physician
 15% ER visit
 7% hospitalized

Control measures – Immunization

19
Q

Bacteria
-affect people up tp 65 y/o or older

Mode of Transmission
 Droplet Spread
 Direct Oral Contact
 Indirect contact with contaminated articles

Incubation
 1 to 3 days

Communicability
 Unknown

Symptoms
 Sudden Onset, Fever, Chest pain, Dyspnea, Productive Cough

Complications
 Pneumonia bacteremia
 Meningitis
 Death occurs in infants & elderly

Control Measures  Immunization

A

PNEUMOCOCCAL PNEUMONIA

20
Q

*do now memorize

Mode of Transmission
• Sexual, perinatal, percutaneous via blood, serum &
vaginal fluids
• Carriers

Incubation
• 45-180 days, usually 60-90days

Communicability
• Many weeks before onset of symptoms, may persist for life (chronic carrier)

Reservoir – humans

Clinical presentation –
 Adults - nausea, vomiting, rash, jaundice
 Asymptomatic in children

Complications –
 Chronic hepatitis, cirrhosis, liver failure, liver cancer

Control measures – Immunization & HBIG to contacts, routine practices to prevent blood & blood products

A

HEPATITIS B

21
Q

One of the most common STIs (70%)

Mode of Transmission
• Vaginal, oral &/or anal intercourse
• Skin to skin transmission

Incubation
• 1-8 months

Communicability
• Active lesions
• Clears within 1-2 years of infection

Reservoir – humans

Clinical presentation –
 painless, warty growths on genital skin or
mucous membrane
 may have no symptoms

Complications
 Cervical Cancer (20 year window)

Control measures – Immunization & screening for cervical cancer (pap smear)

A

HUMAN PAPILLOMAVIRUS (HPV)

22
Q

Reservoir - Humans

Organism
• virus

Mode of Transmission
• Direct contact with respiratory secretions or contaminated particles

Incubation
• 1-4 days

Communicability
• 24 hours before onset of symptoms to 5 days (adults)
• Up to 7 days in children

Clinical presentation
 Sudden onset, fever, chills, headache malaise, cough
 Recovery 10-14 days

Complications – pneumonia, bronchitis, worsening of pre- existing chronic illness, death

Control measures – Immunization, routine practices, antivirals

Flu Watch

4540 Community and Population Health (12 decks)

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