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FCPH > Epidemiology of selected communicable diseases > Flashcards

Epidemiology of selected communicable diseases Flashcards

1
Q

what is the minimal time period required for a country to receive a certificate of elimination ?

A

3 consecutive years

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2
Q

what two diseases have been eradicated globally ?

A

small pox

rinderpest

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3
Q

what is the causative agent of tetanus ?

A

clostridium tetani

anaerobic gram positive bacilli

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4
Q

what is the main reservoir of tetanus ?

A

soil

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5
Q

what are the toxins produced by tetanus ?

A

tetanospasmin and tetanolysin

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6
Q

which toxin of tetanus causes clinical manifestations of tetanus ?

A

tetanospasmin (neurotoxin)

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7
Q

what is the mode of transmission of tetanus ?

A

must pass through the skin barrier “ no wound no tetanus”

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8
Q

what are the presenting symptoms of tetanus ?

A

neurologic which start with headache, muscle stiffness in jaw and difficulty swallowing

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9
Q

what type of individuals are more prone to getting tetanus ?

A

disease almost exclusively happens in unvaccinated individuals

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10
Q

which countries have a higher rate of tetanus ?

A

developing and under developed countries

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11
Q

what prevention protocol is followed for infants and children for tetanus?

A
  1. infants at 2, 4, 6 months are given PENTA vaccine
  2. at 18 months a booster dose of DPT vaccine is given
  3. at school in the 4th year primary grade (Td)
  4. after 10 years a third dose of TT vaccine is given
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12
Q

what prevention protocol should be followed for prevention of tetanus during pregnancy if not previously immunized ?

A
  1. first dose at 6 months
  2. second dose at 7 months
    must be at least 2 weeks before delivery
  3. 3rd dose after 6-12 months or in subsequent pregnancy
  4. 4th and 5th dose each after one year
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13
Q

what is the prevention protocol that should be followed for a previously immunized pregnant woman for rabies ?

A
  1. 2 doses given after the first trimester

2. 3rd dose given after 6-12 months or in the next pregnancy

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14
Q

what is the prevention protocol in adults who are not immunized for tetanus ?

A

monovalent vaccine tetanus toxoid is given to :

soliders , sewage workers, farmers and gardeners

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15
Q

what does the monovalent vaccine tetanus toxoid include ?

A

primary course consists of two doses one month apart

the third dose is given after 6-12 months

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16
Q

if the adult is previously immunised for tetanus what is the best protocol ?

A

one booster dose is given every 10 years

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17
Q

what is the post exposure prophylaxis wound management for tetanus prevention if the patient is completely immunized ?

A

if it is an uninfected wound :

  • less than 10 years from last dose then nothing should be done
  • if more than 10 years from last dose then a booster dose should be given
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18
Q

when can we consider an individual to be immunized from tetanus ?

A

if 2 out of the 5 doses has been taken

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19
Q

if there is a tetanus prone contaminated wound in an immunized individual what is the best next step ?

A

less than 5 years from last dose , then nothing should be done
if it has been more than 5 years: Td vaccine should be taken

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20
Q

if a patient with a wound comes in with incomplete tetanus vaccination what is the next best step in management ?

A
  1. if it is a clean wound : give the age appropriate vaccine along with antibiotics
  2. if it is a contaminated wound then : age appropriate vaccination should be started along with passive immunization (TIG) along with antibiotics ( give immunoglobulins)
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21
Q

how do you immediately care for a case of tetanus ?

A

immediate treatment with human tetanus immune globulin (TIG)

22
Q

how is the rabies virus transmitted ?

A

through direct contact with saliva or brain and NS tissue from an infected animal

23
Q

what is the most common way to get rabies ?

A

bite of a rabid animal

24
Q

what are the symptoms associated with rabies infection ?

A

excitement
excessive salivation
hydrophobia

25
Q

which age group is highly associated with rabies ?

A

age group of under 15

26
Q

what is the most cost effective strategy for preventing rabies in people ?

A

vaccinating dogs

27
Q

what are the two vaccines for rabies ?

A
  1. human diploid cell vaccine (HDCV)

2. rabies vaccine adsorbed (RVA)

28
Q

how many doses are meant to be taken for each vaccine ?

A

each vaccine is associated with 5 doses

29
Q

what is the post exposure management of a human bitten by an animal ?

A
  1. cleansing the wound
  2. wound should not be sutured immediately
  3. tetanus prophylaxis and antibiotics may be indicated
  4. rabies immunoglobulin of human origin
  5. vaccination
30
Q

how is the rabies immunoglobulin dose divided ?

A

half the dose is given through infiltration of the wound and the other half given IM

31
Q

what is the protocol for post exposure prophylaxis for rabies for non immunised individuals?

A 
the first dose is given as soon as possible after the bite 
day 0
day 3
day 14
day 28
32
Q

what is the post exposure prophylaxis for those who have been previously vaccinated for rabies?

A

given 2 doses on days 0 and 3

33
Q

what are the contraindications for post-exposure rabies vaccination ?

A

pregnancy and infancy are not contraindications

34
Q

what are the different categories of contact with suspect rabid animals ?

A

category 1 - touching or feeding animals, licks on intact skin
category 2- nibbing of uncovered skin, minor scratches or abrasions without bleeding
category 3 - single or multiple transdermal bites or scratches , contact with bats

35
Q

what is the best post exposure prophylaxis that should be applied for category 1 patients ?

A

none

36
Q

what is the best post exposure prophylaxis for category II patients ?

A

immediate vaccination and local treatment of the wound

37
Q

what is the best post exposure prophylaxis for category 3 patients ?

A

immediate vaccination n
administration of rabies immunoglobulins
local treatment of the wound

38
Q

what is the reservoir of the polio virus ?

A

man is the only reservoir

39
Q

how does the transmission of poliomyelitis occur ?

A

direct droplet infection n

faeco-oral infection

40
Q

what are the three different presentations of polio virus ?

A
  1. inapparent infection
  2. clinical poliomyelitis abortive polio (minor illness)
  3. involvement of the CNS (major illness)
41
Q

what are the two forms of polio which involves the CNS ?

A

non-paralytic

paralytic polio

42
Q

which clinical presentation of polio is associated with acquired immunity ?

A

inapparent infection

43
Q

what are the presenting symptoms of non paralytic polio ?

A

stiffness and pain in the neck and the back , recovery is rapid

44
Q

what is the presentation of paralytic polio ?

A

involves destruction of the motor cells but not the sensory nerve cells

45
Q

what is the cure for polio ?

A

there is no cure but it can only be prevented

46
Q

when should polio vaccination be administered ?

A 
IPV should be given at :
2 months 
4 months
6 months  
18 months 
4 through 6 years
47
Q

what is the minimum interval between doses of the polio vaccine ?

A

4 weeks

48
Q

what is the minimum age for dose 1 of polio ?

A

6 weeks

49
Q

when should OPV be given ?

A 
at 2 months 
4 months 
6 months 
9 months 
12 months 
18 months
50
Q

why is it important to include OPV to IPV ?

A

OPV provides mucosal immunity and is required to stop person to person spread

51
Q

what is the difference between the terms eradication and endgame ?

A

eradication refers to the wild virus
whilst
endgame refers to management of VDPVs and VAPP

FCPH (39 decks)

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