Communicable Diseases Flashcards
What are three different types of immunity?
Active immunity
Passive immunity
Cross immunity
What is active immunity?
Produced by own immune system.
Long term, in some cases life long.
Natural.
Vaccines.
What is passive immunity?
Transferred from another person. Eg. mother to infant, transfusion of blood products, immune globulins.
Produced by animals (anti toxins).
Temporary.
What is cross immunity?
Immunity from one virus or bacteria provides protection against another.
How early was small pox recorded as an epidemic?
Record of epidemic as early as 1350 BC
What role did small pox play on a global scale?
Instrumental in the destruction of Aztec and Inca empires and decimated the indigenous population in Canada after European contact.
Who developed the small pox vaccine, and when?
Vaccine developed by Dr. E. Jenner in 1796
When did the WHO launch a campaign to eradicate smallpox?
1967 WHO launched campaign to eradicate.
When was small pox declared eradicated?
May 1980
Define “communicable disease”.
A contagious disease of human or animal origin caused by an infectious agent.
What are the characteristics of communicable diseases? (6)
Infectivity Pathogenicity Virulence Toxicity Invasiveness Antigenicity
What is infectivity?
The ability to enter and multiply in the host.
What is pathogenicity?
The ability to produce a specific clinical reaction after infection occurs.
What is virulence?
The ability to produce a severe pathological reaction.
What is toxicity?
The ability to produce a poisonous reaction.
What is invasiveness?
The ability to penetrate and spread throughout a body tissue.
What is antigenicity?
The ability to stimulate an immunological response.
What are the goals of communicable disease control?
To decrease the occurrence, spread, and complications of diseases.
To eliminate and eradicate vaccine-preventable disease.
What are some components of communicable disease control programs?
Immunization Outbreak management Accurate immunization record-keeping Compilation of immunization coverage data Maintenance of vaccine potency Reduction of vaccine wastage Reporting of adverse events.
When was the last polio epidemic in Canada?
1959
When was the polio vaccine developed, and by who?
Developed in 1955 by Dr. Jonas Salk
What does “eliminate” mean? (in respect to communicable diseases)
Remove a disease from a geographical area (eg. country or region).
What does “eradicate” mean? (in respect to communicable diseases)
World wide removal of the disease
What are the responsibilities of federal/provincial/territorial governments?
They control communicable disease programs. Each province has a different one.
What are the steps of developing a vaccine? (4)
- Lab studies
- Pre-clinical goals
- Clinical
- Health Canada approval
What occurs during the lab studies step of developing a vaccine? (first step)
Identify infectious agent
What occurs during the pre-clinical goals step of developing a vaccine? (second step)
Immunogenicity
Safety studies
Who are vaccines being tested on during the pre-clinical goals step of developing a vaccine? (second step)
At this phase, it is being tested on animals.
What are the three phases of the clinical step of developing a vaccine? (third step)
Phase 1 - looking at immunogenicity and local systemic reactions (human reactions at this point)
Phase 2- looking at an optimal dosing schedule in your target population, and ongoing safety assessment.
Phase 3 - looking at immunogenicity of a target population, and ongoing safety assessment.
How many participants are involved in phase 1 of the clinical step of developing a vaccine? (third step)
Participants range from 10 to less than 100
How many participants are involved in phase 2 of the clinical step of developing a vaccine? (third step)
Participants range from 50-500
How many participants are involved in phase 3 of the clinical step of developing a vaccine? (third step)
Participants range from 300-30,000
What is variolation?
Variolation was a technique used by the turks and the Chinese to protect against smallpox. It’s the technique of transferring the infection from an infected person to a non-infected person through a scratch in the skin. The non-infected person would contract a mild infection and survive and be immune for life.
What are the reasons for capitalized letters vs lowercasse letters in vaxine titles? Eg. DTaP vs Tdap
When you see a capital letter, it means you are getting the full dose. A lower case letter means you are getting a reduced dose.
DTaP - Diptheria, Tetanus, acellular Pertussis full doses
vs Tdap - full dose of tetanus with reduced doses of acellular pertussis and diptheria
What are classifications of communicable diseases?
- Agents of bioterrorism
- anthrax
- smallpox
- botulism - Under MHO mandate:
- vaccine preventable
- food-borne water-borne
- vector-borne
- diseases of travelers
- Zoonoses
- Parasitic
- sexually transmitted infections
- tuberculosis
What are some viral vaccine preventable diseases?
Rubeola Mumps Rubella Varicella Hepatitis A and B Influenza Poloimyelitis HPV Rotavirus
What are some examples of bacterial vaccine-preventable diseases?
Dipterhia Tetanus Pertussis Haemophilus influenza type B Invasive pneumococcal disease Meningococcal C
What are some examples of killed/inactivated vaccines?
Meningococcal, diptheria
What are some examples of live attenuated vaccines?
MMR, varicella, flu mist
What are toxoids?
Protect against injury from bacterial toxins but are not bacteriocidal.
What are some examples of toxoids?
Tetanus toxoid
What are immune globulins?
These protect you for a short period of time until your immune system is activated
What is an example of an immune globulin?
Rabies immune globulin
What are some contraindications of receiving a live/attenuated vaccine?
Immunocompromised
Under 12 months of age (these babies are protected by their maternal antibodies)
Received another vaccine within past 28 days
Recent blood transfusion
What route are live/attenuated vaccines given? What about killed/inactivated?
Live attenuated are generally given subcutaneously
Killed/inactivated are generally given IM
What are 6 examples of rashes in infants and children?
Rubeola Rubella Roseola infantum Impetego Fifth disease Hand, foot & mouth disease
What is the appearance of a rubeola rash?
Dusky red blotch rash spreading down from face
What is the appearance of a rubella rash?
Slightly raised, red pinpoint rash spreading from behind ears to face and downward.
What is the appearance of a roseola infantum rash?
Raised red rash on trunk, after 3-4 days of high fever, which spreads to rest of body.
What is the appearance of impetego?
Moist, purulent yellow crusted sores surrounded by redness
What is the appearance of fifth disease? (rash)
Raised, red rash first appearing on cheeks
What is teh appearance of hand, foot and mouth disease? (rash)
Small grayish blisters in mouth, on palms and soles
What are the 7 steps to obtaining informed consent?
- Determine authority
- Determine capability
- Provide standard info
- Confirm understanding of standard info
- Provide opportunity for questions
- Confirm consent
- Document consent or refusal
What are some bacterial food and waterborne diseases?
Campylobacter Salmonella Shigella Yersinia E. Coli Cholera
What are some examples of parasitic food and waterborne diseases?
Amoebiasis
Giardiasis
What is an example of a ciral food and waterborne disease?
Hepatitis A
What are the signs and symptoms of salmonella infection?
fever, chills, nausea, vomiting, diarrhea, abdominal cramping, sudden onset, H.F. I
What is the incubation period of salmonella?
12-72 hours
What is the duration period of salmonella infection?
2-7 days
What are the symptoms of E. coli infection?
severe abdominal cramps, bloody diarrhea
What is the incubation period of E. coli?
Hours to 10 days
What is the duration of E. coli infection?
7-10 days
What are the symptoms of listeria infection?
Nausea, vomiting, diarrhea, cramps, H.A., constipation, can lead to meningitis
What is the incubation period for listeria?
24-72 hours
What is the duration of listeria infection?
24-48 hours
What are vector borne diseases? What’s the difference between biological transmission and mechanical transmission?
Biological transmission: need the vector
Mechanical transmission: An insect simply contacts the infectious agent with its legs, mouth, mouth parts, etc. and carries it to the host.
Which federal laws and branches regulate prevention and treatment of food and water borne diseases?
Canadian Food Inspection Agency Bureau of Food Safety Assessment Pest Management Regulatory Agency Food and Drugs Act Canadian Agricultural Products Act Canadian Environmental Protection Act Meat Inspection Act Health of Animals Act Pest Control Products Act
What provincial laws and branches regulate prevention and treatment of food and water borne diseases?
Canadian Quality Milk Program FoodSafe BC Food Safety Act Drinking Water Protection Act Public Health Inspections
What is the treatment for food and water borne diseases?
Antibiotics only in severe cases
What are the three types of sexually transmitted infections?
Bacterial
Viral
Parasitic
What are some examples of bacterial STI’s?
Chlamydia
Gonorrhea
Syphilis
What are some examples of viral STIs?
HPV
HIV
Hepatits B and C
Herpes
What are some examples of parasitic STIs?
Public lice
Scabies
What are the symptoms of chlamydia in women?
Burning, vaginal discharge, pain with intercourse, lower abdominal pain and pressure
What are the symptoms of chlamydia for males?
Burning with voiding, changes in urethral discharge, itch, pain and swelling in testicles.
What can chlamydia lead to if untreated?
Pelvic inflammatory disease in women (Can lead to infertility)
Pain and swelling in the testicles in men (can also lead to infertility)
What are the four stages of syphilis?
Primary
Secondary
Latent
Tertiary
What happens during the primary stage of syphilis?
A painless sore (chankre) that occurs on the infected area. Someone may not notice this sore.
What occurs during the secondary stage of syphilis?
A rash on your palms and soles of your feet, usually appears 6-10 weeks post exposure
What occurs during the latent stage of syphilis?
Asymptomatic, you can still transmit it during this phase
What occurs during the tertiary stage of syphilis?
10-25 years after infection has occurred, you can experience severe symptoms that impact other body organs (eg. neurosyphilis, cardiac issues)
How can STI’s be prevented?
Abstinence
Limit number of partners
Use condoms
Immunizations
How can STI’s be treated?
Regular check ups
Medications
What is done for peple with STI’s (besides prevention and treatment)?
Contact tracing
What are the aims of contact tracing?
To prevent spread of infection
To minimize the impact of the infection through treatment measures
What is the causative agent in tuberculosis?
Mycobacteriom tuberculosis
How is tubercuclosis transmitted?
Inhalation - almost always airborne and person to person; aerosolized; ingestion
Who is at most risk for TB?
TB and SDOH - crowded living conditions
What is the incubation period of TB?
4-6 weeks
What percentage of people with latent TB develop active TB within 2 years?
5%
What kind of screening is done for TB?
TB skin test
Chest x ray
Sputum
IGRA
What is the treatment for latent TB?
Isoniazid for 9 months
What is the treatment for active TB?
Isolate and have person wear mask until negative sputum.
First line medications are isoniazid and rifampin for 6 months
How often does an influenza pandemic occur?
Occurs every 10-40 years (1918, 1957, 1968, 2009)
What causes an influenza pandemic?
A global epidemic which results from a new viral subtype
What can be done to mitigate the impact of influenza pandemic?
BC pandemic influenza preparedness plan
- Minimize spread of the virus
- minimize serious illness and death
- curtail societal disruption
What are some elements of vaccine safety?
Production of biological products
Cold Chain – Transport, handling, conservation
Knowledge about
Contraindications
Routine precautions
Informed consent
Vaccine administration
3 checks & 7 rights
Reconstitution & drawing up
Site selection & stabilizing the muscle
Anaphylaxis, post-vaccine supervision & vaccine associated adverse events
How can communicable diseases be controlled at the health unit level?
Surveillance
CD investigation and follow-up
What is surveillance of communicable disease?
Ongoing collection and analysis of data to identify problems or trends
Detection of cases, outbreaks and epidemics
Implementation of policies or interventions to prevent the spread of the disease
What does communicable disease investigation/follow-up involve?
Case reported
Diagnosis - lab confirmed or based on clinical symptoms
Contact index case and identify and notify contacts
Chemoprophylaxis
Follow up
Classify
What are barriers to communicable disease control?
Globalization and urbanization Natural disasters Environmental changes Cost of vaccines, public education, human resources Public opinion Anti-immunization movement
Who/which organizations form partnerships for communicable disease control?
WHO
Federal agencies - immigration, agriculture
Federal/Provincial/Territorial collaboration, DND, PHAC, Pharmaceutical companies
BCCDC, legal authority extended to PHO
Health authorities, school districts, infection control nurses, physicians, pharmacists, EHO’s
What are some international barriers to effective prevention and control of communicable diseases?
Globalization and urbanization
Natural disasters
Environmental changes
What are some national barriers to effect prevention and control of communicable diseases?
National immunization strategy continues to develop
Federal/Provincial/Territorial responsibilities for healthcare
What are some provincial barriers to effective prevention and control of communicable diseases?
Cost of vaccines, public education, human resources to administer programs
What are some local barriers to effective prevention and control of communicable diseases?
Public opinion
Anti-immunization sentiment
What are some reasons for anti-immunization sentiments?
Alternative providers Libertarian views Safety and efficacy Personal beliefs Apathy/no need
What are the five types of attitudes towards immunization?
Uninformed but educable. Misinformed but correctable. Well-read and open minded. Convinced and content. Committed and zealous.
What are “uninformed but educable” people’s attitudes towards immunization?
Want information ; chance of positive outcome (immunization) is high
What are “misinformed but correctable” people’s attitudes towards immunization?
Typically have not been presented with the other side of the argument; may need time to consider new information and will return to the clinic.
What are “well-read and open minded” people’s attitudes towards immunization?
Well informed; want help differentiating information
What are “convinced and content” people’s attitudes towards immunization?
Don’t usually come to community health clinics; discussion is seldom productive
What are “committed and zealous” people’s attitudes towards immunization?
Not open to information that is not consistent with their perspective; no point in entering into a discussion; agree to disagree
What are some ways to communicate risk/benefit regarding vaccines? (7)
Listen
Recognize parental concerns are legitimate
Provide context
Refute misinformation
Provide valid information and additional resources
Recognize that it is an individual decision
Make a clear recommendation
How should we as nurses listen in providing risk/benefit communication about vaccines?
Assess attitudes towards immunization.
Identify specific parent concerns.
Tailor information to these concerns.
Why are parental concerns about vaccines legitimate?
Adverse events are associated with vaccines
How should we as nurses provide context about immunization? (part of risk/benefit communication)
Diseases are less fruequent, not gone.
Educate about potential consequences.
Comparative risks of disease vs. vaccine-related events.
Provide examples of re-emergence of disease.
How should we as nurses refute misinformation about immunization? (part of risk/benefit communication)
Be current on most recent anti-immunization claims.
Be familiar with various web sites.
Respond with reliable data.
How should we as nurses provide valid information and additional resources about immunization? (part of risk/benefit communication)
Refer parents to credible sources (PHAC, Immunize BC or BCCDC)
Why should nurses recognise that immunization is an individual decision?
Immunizations are not compulsory in Canada.
Why should nurses make a clear recommendation about immunization?
People look to health care providers for advice and recommendations.
What are the “four C’s” of the art of communication? (regarding immunization)
Concise language
Correct information
Compassion
Consistency and creativity
What is the definition of harm reduction?
A pragmatic public health approach aimed at reducing the adverse health, social and economic consequences of at-risk activities.
What are the 3 R’s of immunization? (when travelling)
Routine - tetanus, polio, measles, hepatitis B, etc.
Required for protection in a country you are visiting - eg. yellow fever, cholera, meningococcal, etc
Recommended - hepatitis A, typhoid
What are some examples of mosquito-borne diseases?
Yellow fever, Japanese encephalitis, denge fever, malaria
