Diphtheria, Tetanus, Pertussis, Polio, H. Influenzae B Flashcards
What causes diphtheria?
bacterial infection caused by Corynebacterium diphtheria
-releases toxin –> inhibit cell protein synthesis & membrane formation
How is diphtheria transmitted?
respiratory droplets (e.g. sneezing or coughing)
What are the signs and symptoms of diphtheria?
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)
What is the mortality rate of diphtheria?
unimmunized 5-10%
highest in very young/old individuals
How does the diphtheria vaccine work?
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
How does the diphtheria come in terms of available products?
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
Should children receive the diphtheria vaccine?
yes, part of routine immunizations
Describe NACI’s recommendations for diphtheria vaccination in adults.
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
What causes tetanus?
bacterial infection caused by Clostridium tetani
-found in the soil & feces
-releases a neurotoxin
How is tetanus transmitted?
wound contamination with soil, feces, or dust
not spread person-to-person
What are the signs and symptoms of tetanus?
onset 3-21 days
painful muscle spasms beginning with jaw muscles (lockjaw)
What are the complications of tetanus?
convulsions
respiratory failure
What is the mortality rate of tetanus?
unimmunized 10-80%
-highest in very young/old individuals
How does the tetanus vaccine work?
toxoid vaccine
-contains detoxified tetanus toxin (antigen), so immune system produces antibodies towards the toxin
How does the tetanus vaccine come in terms of available products?
only available as combo vaccine
-DTaP-IPV, Tdap, Td
Should children receive the tetanus vaccine?
part of routine immunizations
Describe NACIs recommendations for tetanus vaccine in adults.
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
What causes pertussis?
bacterial infection caused by Bordetella pertussis
-produce toxin –> paralyze respiratory cell cilia
How is pertusiss transmitted?
respiratory droplets (e.g. sneezing or coughing)
close face-to-face contact (highly contagious)
When are people with pertussis considered to be contagious?
catarrhal stage (1-2 weeks)
first two weeks after cough onset
Can you contract pertussis multiple times in your life?
can contract more than once
immunity wanes over time
What are the complications of pertussis?
complications most often seen in infants
pneumonia
seizures
encephalopathy
How does the pertussis vaccine come in terms of available products?
only available as acellular preparation in a combination vaccine
-aP = pediatric formulation (increased concentration)
-ap = adolescent/adult formulation (reduced concentration)
Does the pertussis vaccine lead to seizures?
myth
-old vaccine (whole cell) –> seizures
Should children receive the pertussis vaccine?
part of routine immunizations
Describe the NACI recommendations for pertussis vaccine in adults.
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
What causes polio?
viral infection caused by Poliovirus
-3 serotypes (1, 2, 3)
How long has Canada been “polio free” for?
since 1994
How is polio transmitted?
fecal-oral
What are the signs and symptoms of polio?
70-95% asymptomatic
flu-like (fever, HA, sore throat), NV, weakness
What are the complications of polio?
meningitis
limps
post-polio syndrome paralysis
What are the mortality rates for polio?
paralytic polio:
-children 2-5%
-adults 15-30%
How does the polio vaccine come in terms of available products?
inactivated poliomyelitis vaccine
-available as combo vaccine (Tdap-IPV) or individually
-vaccine contains 3 types of wild poliovirus - trivalent
Which version of the polio vaccine has been phased out in Canada and why?
live attenuated oral polio vaccine (OPV)
-associated with paralytic polio
-used internationally
When is the polio vaccine typically given?
childhood
Do adults need a polio booster?
no routine booster
-booster if increased risk of exposure
What causes Haemophilus influenzae type b?
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
How is Hib transmitted?
respiratory droplets
Which patient population is most commonly impacted by Hib in Canada?
most commonly infects children under 5 years old
What are the complications of Hib?
acute otitis media
meningitis
pneumonia
bacteremia
epiglottis
death rate up to 5%
deafness up to 20%
How does the Hib vaccine come in terms of available products?
combo vaccine (DTap-IPV-Hib) or individually
When is the Hib vaccine given?
childhood
Do adults need Hib vaccine boosters?
no routine boosters
