Diphtheria, Tetanus, Pertussis, Polio, H. Influenzae B

Question 1

What causes diphtheria?

Answer 1

bacterial infection caused by Corynebacterium diphtheria
-releases toxin –> inhibit cell protein synthesis & membrane formation

Question 2

How is diphtheria transmitted?

Answer 2

respiratory droplets (e.g. sneezing or coughing)

Question 3

What are the signs and symptoms of diphtheria?

Answer 3

URTI - mild fever, sore throat, lymphadenopathy
a grayish white membrane appears in throat in 2-3 days
can lead to acute respiratory distress & systemic complications (e.g. myocarditis)

Question 4

What is the mortality rate of diphtheria?

Answer 4

unimmunized 5-10%
highest in very young/old individuals

Question 5

How does the diphtheria vaccine work?

Answer 5

toxoid vaccine
-contains detoxified diphtheria toxin (antigen), so immune system produces antibodies towards the toxin
-vaccine protects against effects of the toxin, but not infection/transmission

Question 6

How does the diphtheria come in terms of available products?

Answer 6

only available as combo vaccine
-“D” = pediatric formulation (higher concentration antigen), e.g. DTap-IPV
-“d” = adolescent/adult formulation (reduced concentration antigen), e.g. Tdap

Question 7

Should children receive the diphtheria vaccine?

Answer 7

yes, part of routine immunizations

Question 8

Describe NACI’s recommendations for diphtheria vaccination in adults.

Answer 8

Td booster every 10 yrs (routine)
-can also get if serious cuts/deep wounds & last tetanus vaccine was more than 5 yrs ago
-should receive Tdap x 1 to replace Td booster
should receive Tdap vaccine in each pregnancy

Question 9

What causes tetanus?

Answer 9

bacterial infection caused by Clostridium tetani
-found in the soil & feces
-releases a neurotoxin

Question 10

How is tetanus transmitted?

Answer 10

wound contamination with soil, feces, or dust
not spread person-to-person

Question 11

What are the signs and symptoms of tetanus?

Answer 11

onset 3-21 days
painful muscle spasms beginning with jaw muscles (lockjaw)

Question 12

What are the complications of tetanus?

Answer 12

convulsions
respiratory failure

Question 13

What is the mortality rate of tetanus?

Answer 13

unimmunized 10-80%
-highest in very young/old individuals

Question 14

How does the tetanus vaccine work?

Answer 14

toxoid vaccine
-contains detoxified tetanus toxin (antigen), so immune system produces antibodies towards the toxin

Question 15

How does the tetanus vaccine come in terms of available products?

Answer 15

only available as combo vaccine
-DTaP-IPV, Tdap, Td

Question 16

Should children receive the tetanus vaccine?

Answer 16

part of routine immunizations

Question 17

Describe NACIs recommendations for tetanus vaccine in adults.

Answer 17

Td booster every 10 years (routine)
-can also get if serious cuts/deep wounds & last tetanus vaccine was more than 5 years ago
-should receive Tdap x 1 to replace Td booster
should receive Tdap vaccine in each pregnancy

Question 18

What causes pertussis?

Answer 18

bacterial infection caused by Bordetella pertussis
-produce toxin –> paralyze respiratory cell cilia

Question 19

How is pertusiss transmitted?

Answer 19

respiratory droplets (e.g. sneezing or coughing)
close face-to-face contact (highly contagious)

Question 20

When are people with pertussis considered to be contagious?

Answer 20

catarrhal stage (1-2 weeks)
first two weeks after cough onset

Question 21

Can you contract pertussis multiple times in your life?

Answer 21

can contract more than once
immunity wanes over time

Question 22

What are the complications of pertussis?

Answer 22

complications most often seen in infants
pneumonia
seizures
encephalopathy

Question 23

How does the pertussis vaccine come in terms of available products?

Answer 23

only available as acellular preparation in a combination vaccine
-aP = pediatric formulation (increased concentration)
-ap = adolescent/adult formulation (reduced concentration)

Question 24

Does the pertussis vaccine lead to seizures?

Answer 24

myth
-old vaccine (whole cell) –> seizures

Question 25

Should children receive the pertussis vaccine?

Answer 25

part of routine immunizations

Question 26

Describe the NACI recommendations for pertussis vaccine in adults.

Answer 26

Td booster every 10 years -should receive Tdap x 1 to replace Td booster (vaccinate for pertussis once in adulthood) -recommended all parents/extended family/caregivers if havent received as an adult to limit transmission to un/undervaccinated children should receive Tdap vaccine in each pregnancy

Question 27

What causes polio?

Answer 27

viral infection caused by Poliovirus -3 serotypes (1, 2, 3)

Question 28

How long has Canada been "polio free" for?

Answer 28

since 1994

Question 29

How is polio transmitted?

Answer 29

fecal-oral

Question 30

What are the signs and symptoms of polio?

Answer 30

70-95% asymptomatic flu-like (fever, HA, sore throat), NV, weakness

Question 31

What are the complications of polio?

Answer 31

meningitis limps post-polio syndrome paralysis

Question 32

What are the mortality rates for polio?

Answer 32

paralytic polio: -children 2-5% -adults 15-30%

Question 33

How does the polio vaccine come in terms of available products?

Answer 33

inactivated poliomyelitis vaccine -available as combo vaccine (Tdap-IPV) or individually -vaccine contains 3 types of wild poliovirus - trivalent

Question 34

Which version of the polio vaccine has been phased out in Canada and why?

Answer 34

live attenuated oral polio vaccine (OPV) -associated with paralytic polio -used internationally

Question 35

When is the polio vaccine typically given?

Answer 35

childhood

Question 36

Do adults need a polio booster?

Answer 36

no routine booster -booster if increased risk of exposure

Question 37

What causes Haemophilus influenzae type b?

Answer 37

bacterial infection caused by H. influenzae serotype b -6 serotypes "a" to "f" (typeable, encapsulated) -Hib is the most pathogenic -since Hib vaccine, most invasive disease due to non-b H. influenzae in Canada

Question 38

How is Hib transmitted?

Answer 38

respiratory droplets

Question 39

Which patient population is most commonly impacted by Hib in Canada?

Answer 39

most commonly infects children under 5 years old

Question 40

What are the complications of Hib?

Answer 40

acute otitis media meningitis pneumonia bacteremia epiglottis death rate up to 5% deafness up to 20%

Question 41

How does the Hib vaccine come in terms of available products?

Answer 41

combo vaccine (DTap-IPV-Hib) or individually

Question 42

When is the Hib vaccine given?

Answer 42

childhood

Question 43

Do adults need Hib vaccine boosters?

Answer 43

no routine boosters