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Communicable disease control > Diseases > Flashcards

Diseases Flashcards

1
Q

Duration of yellow fever vaccine
Exemptions
Precautions

A

Lifelong

Exemptions: age

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2
Q

Yellow fever:

  1. Genus
  2. Incubation period
  3. Infectious period
A
  1. Flavivirus
  2. 3-6 days
  3. Just before fever for 3-5 days
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3
Q

Measles

  1. Incubation period
  2. Reproductive rate
  3. Infectious period
  4. Timing of rash
A
  1. 7 - 18 days (usually 10 days)
  2. 15-18
  3. 1 day prior to prodromal illness to 4 days after rash appearance
  4. rash appears day 3-4 and lasts 4-7 days
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4
Q

Listeria

  1. Incubation period
  2. Period of communicability
  3. Risk factors
  4. Source
  5. Diagnosis
A
  1. 3-70 days (median 3 weeks)
  2. 7-10 days (mother to baby)
  3. Pregnant women/fetuses, newborns, immunosuppression
  4. contaminated food particularly cheese, ready-to-eat meals and salads, deli meats, pate
  5. Usually blood cultures or another sterile site (e.g. CSF)
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5
Q

Define a community outbreak of IMD

A

3 or more confirmed or probable cases of IMD with no direct epidemiologic link within a defined area within 3 months with a primary attack rate of 10 per 100 000

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6
Q

What changes in epidemiology of meningococcal disease are suggestive of an outbreak? (3)

A
  • increased rate of disease (or increase in number in small populations)
  • clustering of cases in an age group or a shift in the age distribution of cases
  • phenotyphic or genetic similarity among cases
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7
Q

Define an organisation-based outbreak of IMD

A

2 or more probable or confirmed cases within 4 weeks among an organisation e.g. high school but no close contact with each other

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8
Q

What are the national case definitions for measles:

  1. Confirmed case
  2. Probable case
A
  1. Confirmed case = lab definitive evidence, or
    clinical and epi evidence
  2. Probable case = lab suggestive evidence and clinical evidence.
    clinical evidence = generalised maculopapular rash for 3 or more days + fever>38 at time of rash onset + [cough or coryza or conjunctivitis or koplik spots]
    **epi evidence = contact with an infectious/suspected case
    **    lab-suggestive evidence: IgM detected by a non-reference lab (except if recently had measles vaccine)
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9
Q

Measles lab tests:
<3 weeks
>3 weeks

A

3 weeks: nasopharyngeal swab and urine for NAT and culture. Blood for serology and WGS
>3 weeks: serology

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10
Q

Measles

  1. what are the r/f for severe disease?
  2. what are the potential complications?
  3. what is the case fatality?
A
  1. R/F: young children, malnutrition, vitamin A deficiency
  2. haemorrhagic rash, protein-losing enteropathy, otitis media(6%), severe skin infections, pneumonia (9%)
    - exacerbation of vitamin A deficiency -> blindness
    Subacute sclerosing panencephalitis (1/100 000) several years after infection
  3. Case fatality 3-5% in developing countries
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11
Q

What is the incubation period of hepatitis A?

A

15-50 days (commonly 28-30)

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12
Q

What is the infectious period of hepatitis A?

A

from a few days prior to illness to a few days after jaundice

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13
Q

Case definition for hepatitis A

  1. Confirmed case
  2. Probable case
A
  1. Confirmed = Lab-definitive evidence (IgM or NAT)

2. Probable = Clinical and epi evidence

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14
Q
  1. For hepatitis A contacts who should you consider post-exposure prophylaxis (vaccine or Ig)>
  2. which groups should receive NHIG?
A
  1. -household or sexual contacts
    - if case in childcare centre -> contacts
    - if case in food handler -> contacts who ate food prepared or other food handlers
    Use NHIG for
    -
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15
Q

What is the incubation period of IMD?

A

1-7 days (up to 10)

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16
Q

What are the case definitions for IMD?

confirmed and probable

A

Confirmed case = lab definitive evidence (isolation of N. meningitidis from a sterile site, or NAT)
OR lab-suggestive (gram neg diplococci or IgM) and clinical evidence (clinically compatible illness)
Probable case = clinical evidence

17
Q

What are the main considerations during an outbreak of IMD?

A
  • Establish a team, lab-communication and comms
  • Confirm the diagnosis and serotype
  • Active surveillance: age-specific or region-specific rates
  • Information provision early: public (media releases, press conference), HCW, prepare for increase in calls
  • Manage contacts: clearance ABx
  • Consider vaccination depending on strain and size of organisation or community
18
Q

Who are the at-risk contacts and other groups for meningococcal disease?

A 
contacts:
-household or other intimate
-childcare/school/uni
-HCW
- lab workers
Other: 
-Immunosuppressed
-ATSI
-crowding/smoke exposure
19
Q

What is the incubation period for Legionella?

A

Legionnaires disease: 2-10 days (usually 5-6)

Pontiac fever: 5-72 hous (usually 1-2 days)

20
Q

What are the diagnostic tests for Legionella?

A

LP antigen in urine (in Tas just LP1)
4-fold rise in titre of LP of 3-6 weeks
Culture

21
Q

When do you start investigating a cluster of Legionnaire’s disease?

A

2 or more cases with a common exposure (within 100m) over a 3 month period

22
Q

What are the most likely potential sources of a legionella outbreak?

A

Aerosolised water (e.g. veg section of supermarket)

  • car washes
  • cooling towers (e.g. shopping centres, clubs)
  • spas
  • fountains
  • warm water systems
23
Q

What is the incubation period for zika virus?

What is the typical duration of illness for Zika virus?

A

3-12 days

duration: 4-7 days

24
Q

What is the incubation period for pertussis?

A

4-21 days (usually 7-10)

25
Q

What is the incubation period for varicella zoster (chickenpox) virus?

A

10-21 days (usually 14-16)

26
Q

What is the SAFE strategy for trachoma?

A

Surgery
Antibiotics
Facial cleanliness
Environmental health

27
Q

What is considered endemic trachoma?

A

Prevalence of active trachoma >5% in ATSI children aged 5-9 years or prevalence of trichiasis of >0.1%in the adult ATSI population

28
Q

What are the case definitions for Zika virus?

A

Confirmed and probable notifiable as flavivirus infection (unspecified)
Confirmed: lab definitive evidence (NAT, virus isolation, IgG seroconversion or fourfold rise in titre, IgM in CSF) and clinical evidence
Probable: lab suggestive evidence and epi evidence (travel to zika country within 2 weeks or sexual exposure to a confirmed/probable case)
Clinical evidence: acute illness within 2 weeks of exposure and 2 or more of fever, headache, myalgia, arthralgia, rash, non-purulent conjunctivitis

29
Q

What are the current diseases of concern under the Biosecurity Act 2015?

A 
SARS
MERS
Viral haemorrhagic fever
Human influenza with pandemic potential
Plague
Smallpox
Yellow fever (in northern Australia)
30
Q

What is meningococcal disease and how many serogroups are there?
- which are the most common?

A

Neisseria meningitidis, gram negative bacteria
16 serogroups known
ABCWY are the most common globally

31
Q

What is the case fatality for pertussis in babies < 6 months?

A

0.5-0.8%

32
Q

Measles post-exposure prophylaxis
<72 hours
>72 hours

A

<72 if not immune (born after 1966 and no record of 2xMMR or serology): MMR vaccine
- NHIG if: immunocompromised, babies<8 months, pregnancy
>72 hours: NHIG if <18 months, pregnant, immunocompromised. Also HCW and close contacts if NO previous vaccines.

33
Q

What are the recommendations for isolation of susceptible contacts of a case of measles?

  1. childcare attendees or primary schools
  2. adult in regular workplace or tertiary education
A
  1. isolate for 14 days after initial case developed rash
    - 3 days only if given MMR
    - 6 days if given NHIG
  2. don’t isolate, just educate
34
Q

Who are the priority contacts to follow up for a case of pertussis?

A

Children <5 years, particularly babies<6 months
People in contact with babies <6 months (e..g childcare workers)
Pregnant women in T3

35
Q

What are the current antibiotic options for treatment of pertussis?

A

azithromycin, clarithromycin, erythromycin, Bactrim

36
Q

Definition of a contact of pertussis

  • close contact
  • general contact
  • high risk
A

during infectious period:
close contact: stayed overnight or lived in house together
general contact: face-to-face exposure (within 1 metre) for atleast 1 hour
high-risk: babies<6 months or people who may transmit pertussis to them (including maternity wards, nurseries)

37
Q

Who should receive antibiotic prophylaxis against pertussis?

A

If within 14 days of contact with an infectious case and <6 months of age or close contact of baby <6 months of age
ie. all household contacts of a baby <6 months and all childcare contacts (other kids in room and staff of a baby <6 months, pregnant women in T3, maternity or nursery staff)

Communicable disease control (2 decks)

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