Immunisation and prophylaxis Flashcards
Immunity can be divided into either?
innate - body’s own, white cells - neutrophils and lymphs, antibodies
Adaptive - natural - active- measles, chicken pox or passive- breast milk
Antibody Response to Infection - antibodies form
IgM then IgG
Antibody Response to Infection - antibodies form much quicker in a
secondary response
vaccines can be either
live or killed (antibody - need more doses)-
who was the pioneer of smallpox vaccination
Edward jenner - small pox vaccine
Give some examples of Live attenuated Vaccines (8)
Measles, mumps, rubella (MMR) BCG Varicella-zoster virus Yellow fever Smallpox Typhoid (oral) Polio (oral) Rotavirus (oral)
Give some examples of Inactivated (killed) vaccines? (9)
inactive - 2 or 3 doses Polio (in combined vaccine D/T/P/Hib) Hepatitis A Cholera (oral) Rabies Japanese encephalitis Tick-borne encephalitis Influenza
Give some examples of detoxified exotoxin (2) - how does this process work
Diphtheria, Tetanus
toxin - treats with formulae till its inactive - inject patient with toxoid - antibodies produced
Give examples of Subunit vaccines (7)
Pertussis (acellular) - whooping cough Haemophilus influenzae type b Meningococcus (group C) conjugated: capsular polysaccharide antigen & Corynebacterium diphtheria protein Pneumococcus Typhoid Anthrax Hepatitis B
Recombinant vaccines e.g. Hepatitis B - subunit PROCESS
DNA segment coding for HBsAg
- removed, purified, mixed with plasmids
- inserted into yeasts
- fermented
- HBsAg produced
6 in 1” vaccine: Infanrix hexa - CHILDHOOD SCHEME - what does it involve
D=purified diphtheria toxoid
T=purified tetanus toxoid
aP= purified Bordetella pertussis
IPV= inactivated polio virus
Hib= purified component of Haemophilus influenzae b
HBV= hepatitis B rDNA
UK Childhood Immunisation Schedule, 2, 3 and 4 months
2 months: 6-in-1 vaccine + pneumococcal conjugate + rotavirus (prevent enteric disease) + Men B
3 months: 6-in-1 vaccine + rotavirus
4 months: 6-in-1 vaccine + pneumococcal conjugate + Men B
UK Childhood Immunisation Schedule: 1 year, 2-8 years, 3-5 years, Girls 12-13 years, 14 years
1 year - Hib/Men C+ MMR + pneumococcal conjugate + men B
2 years - influenza nasal
3 years - 4-in-1 booster (DTaP/IPV) + MMR
4 years - Human papilloma virus
5 years - 3-in-1 booster (dT/IPV) + Men ACWY
Immunisation for special patient and occupational groups - give examples of what will be given (6)
BCG influenza pneumococcal hepatitis B varicella-zoster (chickenpox) herpes-zoster (shingles)
Describe the BCG - who will be offered it (4)
Bacille Calmette-Guerin (BCG) vaccine
- Some infants (0-12 months) - high annual incidence
- children screened for TB risk factors
- new immigrants
- healthcare workers
influenza vaccine is a
single dose vaccine
- influenza A and B often change
influenza vaccine - indications examples (7)
- Age >65 years
- Nursing home residents
- Some health care workers
- Immunodeficiency,
- Immunosuppression
- pregnant women
- diabetes and some chronic conditions
Two pneumococcal vaccines are known as ? when are they used
pneumococcal conjugate polysaccharide vaccine (13 serotypes): Prevenar13®
Part of childhood immunisation schedule
3 doses
pneumococcal polysaccharide vaccine (23 serotypes) Pneumovax II ®
for those at increased risk of pneumococcal infection
single dose
hepatitis B vaccination is given to
All new born children from 2018 - the 6 in 1
- HCW, children at risk of exposure
varicella-zoster (chickenpox) vaccine is offered to - what kind of vaccine is it?
- a suppressed immune systems
- children if in contact with those at risk of severe vzv
- Health case workers (if sero-neg and in contact with patients)
- Live attenuated virus
2 doses, 4-8 weeks apart
herpes-zoster (shingles) vaccine is given to ? what kind of virus is it?
- elderly- 70-80
- live attenuated virus
- Zostavax
Passive Immunisation with Immunoglobulins- Human normal immunoglobulin - what is it? when is it used and what can it treat?
- from blood transfusion service
- antibodies against hep A, rubella and measles
- immunoglobulin deficiencies
- treatment of some autoimmune disorders . myasthenia gravis
Conditions that can be treated with Disease specific immunoglobulin? (6)
hepatitis B Ig rabies Ig tetanus anti-toxin Ig Varicella zoster (chickenpox) Ig diphtheria anti-toxin Ig (horse) botulinum anti-toxin Ig
- used following exposure to infection
Immunisation and Prophylaxis for Travellers - what should be included in a risk assessment? (8)
- Health of Traveller - healthy or immunocompromised?
- Previous immunisation and prophylaxis
- Area to be visited
- Duration of visit
- Accommodation
- Activities
- Remote areas
- Recent outbreaks
Travel Advice would include? (3)
General Measures
Immunisation
Chemoprophylaxis
General Measures - advice for travellers (7)
- Care with food/water
- Hand washing
- Sunburn / Sunstroke
- Altitude
- Road traffic accidents
- Safer sex
- Mosquitoes - bed nets, sprays, “cover up”
Common Immunisations for Travellers?
Tetanus Polio Typhoid Hepatitis A Yellow fever Cholera
Immunisation for Travellers in Special Circumstances - vaccines they may need?
Meningococcus A, C, W, Y Rabies Diphtheria Japanese B encephalitis Tick borne encephalitis
Prophylaxis - examples
Chemoprophylaxis against Malaria
- Post-exposure prophylaxis* - ciprofloxacin
- HIV post-exposure prophylaxis
- Surgical antibiotic prophylaxis
ABCD of Malaria Prevention
- Awareness of risk
- Bite prevention
- Chemoprophylaxis
- Diagnosis and treatment
Bite prevention for malaria
Cover-up at dawn and dusk
Insect repellent sprays, lotions (DEET)
Mosquito coils
Permethrin-impregnated mosquito nets
Chemoprophylaxis against malaria (4 main)
Malarone ® (proquanil & atovaquone) daily
doxycycline daily
Not for children <12 years, photosensivity
mefloquine weekly
Side effects: psychosis, nightmares (1:10,000)
Avoid if history of psychosis, epilepsy
chloroquine weekly + proquanil daily
For vivax/ovale/malariae only
Malaria Advice to Travellers on Return
Any illness occurring within 1 year, and especially within 3 months, of return might be malaria
should seek attention if you become sick particularly wishing 3 months, eg fever, sweats, vomiting
