Immunisation and prophylaxis Flashcards
2 types of adaptive immunity
natural and artificial
2 types of natural adaptive immunity
passive - maternal
active - infection
2 types of artificial adaptive immunity
passive - ab transfer
active - immunisation
Briefly describe the significance of Edward Jenner
pioneer of smallpox vaccine in 1798
those with cowpox never got smallpox so injected pus from cowpox pustule into boy
4 types of vaccine
live attenuated
inactivated - killed
detoxified exotoxin
subunit of microorganism eg recombinant
5 live attenuated vaccines
MMR BCG VZV smallpox yellow fever
who may live attenuated vaccines cause infection in?
immunocompromised
How do live attenuated vaccines work?
live and replicating and stimulate the immune system
5 inactivated vaccines
polio hep A cholera rabies influenza
What is used to change the toxin to a toxoid?
formalin
2 examples of detoxified exotoxin vaccines
diphtheria and tetanus
list some subunit vaccines
H influenza B
pneumococcus
hep B
typhoid
Briefly explain the process of creating a recombinant vaccine eg hep B
DNA segment coding HBsAG which is removed, purified and mixed with plasmids - insert into yeast
fermented and HBsAG produced
Briefly explain immunological memory
primary response is slow and small and IgM raises and then IgG
secondary response is a faster and larger response
Difference in killed and live vaccine response
killed need 2 or 3 doses to build up the response
live vaccine replicated and stimulates host immune system
name the 6 in 1 vaccine
purified diphtheria toxoid purified tetanus toxoid purified bordetella pertussis inactivated polio virus purified component of H influenza B hep B rDNA
Some immunisations used for special patient and occupational groups
pneumococcal, BCG, influenza, hep B, HZV and VZV
Special groups given BCG
TB risk is high
Indications for influenza vaccine
pregnancy coeliac chronic kidney, liver, cardiac, lung disease DM healthcare workers immunosuppression over 65
2 types of pneumococcal vaccine
conjugate and non conjugated
conjugated pneumococcal vaccine info
13 serotypes given in 3 doses
childhood immunisation schedule
Non conjugated pneumococcal vaccine info
23 serotypes given in a single dose
increased risk of pneumococcal infection
conjugate
bound with something else to make it more immunogenic
Who is Hep B vaccine given to?
children - 6 in 1 - 0,1,2 months and 1 year
healthcare workers, IVDU, MSM, high risk children
Who is given the VZV vaccine?
suppressed immune systems
sero negative healthcare workers
children in contact
treatment scheme of VZV vaccine
live attenuated vaccine given 2 doses 4 weeks apart
Who is given the HZV vaccine?
elderly (70-80)
When is human normal Ig given?
ab for hep A, rubella, measles
Ig deficiencies, autoimmune disorders eg myaesthenia gravis
Disease specific Ig examples
hep B, rabies, tetanus, varicella, diphtheria, botulinum
Risk assessment of travellers
area of travel, duration, remote areas previous immunisations and prophylaxis health of traveller accommodation and activities recent outbreaks
General measures for travellers
care with food and drink handwashing sunburn and sunstroke altitude eg Peru road traffic accidents safer sex mosquitos
Common immunisations for travellers
tetanus polio hep A typhoid cholera yellow fever
Special circumstances immunisations for travellers
rabies diphtheria Japanese B encephalitis tick borne encephalitis meningococcus ACWY
4 examples of antimicrobial prophylaxis
chemoprophylaxis against malaria
PEP eg ciprofloxacin for meningococcal
HIV PEP
surgical antibiotic
ABCD of malaria
awareness of risk
bite prevention
chemoprophylaxis
diagnosis and treatment
bite prevention measures
permethrin impregnated mosquito nets
cover up dusk and dawn
mosquito coils
insect repellent sprays and lotions (DEET)
Chemoprophylaxis regime for malaria
malarone (proquanil and atovaraquone)
doxycycline
mefloquine
chloroquine
Doxycycline CI
photosensitivity and not in children under 12
Mefloquine CI
psychosis and nightmares
not in those with epilepsy or psychosis
Advice to travellers on return re. malaria
illness within 1 year back and especially first 3 months can be malaria
