Immunisation Schedule UK Flashcards

1
Q

What is included in the 6 in 1 vaccine?

A
Diphtheria
Tetanus
Pertussis 
Polio
HiB 
Hep B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is the 6 in 1 vaccine given?

A

8 weeks
12 weeks
16 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the diphtheria organism

A
Corynebacterium diphtheria 
Toxin producing gram positive bacteria 
Respiratory droplet spread from coughing or sneezing
Infectious for 4 weeks 
Incubation 3-5 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe th clinical features of diphtheria

A

Toxin kills cells in mouth, nose, throat
Dead cells can build up to form a membrane that can cause choking
- membranous pharyngitis
- fever
- enlarged anterior cervical LNs
- oedema of soft tissue ‘bull neck’

Systemic disease:

  • myocarditis can lead to HF
  • neurological manifestations e.g nerve inflammation leading to paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Has immunisation practically eradicated diphtheria in the UK?

A

Yes

But remains serious threat worldwide, with many endemic areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the tetanus organism

A

Gram positive rod shaped bacillus
Under suitable conditions forms spores that are very hardy, found in soil, dust, manure
Transmission: enter body through wounds, spores produce tetanospasmin (potent toxin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the clinical features of tetanus?

A

Toxins enter nervous system - block inhibitory neurotransmitters at motor nerve endings - widespread activation of motor neurons

  • muscle spasm throughout body
  • begin at head: lockjaw and moves down
  • spasm cont for several weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is tetanus treated?

A

Debride and clean wound
IVIG
Sedation
Muscle relaxation/ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is tetanus transferred person to person?

A

No - can not prevent with herd immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What percentage die from tetanus?

A

1 in 10 even in UK

Mortality up to 90% if no good medical care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In the UK there are a small number of cases of tetanus each year in…

A

Unvaccinated elderly

Contaminated needles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

There has been a marked decline in pertussis incidence with immunisation, but epidemics recur when…

A

Immunisation rates fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Following an increasing number of infants less than 3 months with pertussis in UK, what has now been recommended?

A

Pregnant women now recommended to have pertussis immunisation from 20w gestation (booster dTaP/IPV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is whooping cough transmitted?

A

Respiratory droplet spread by coughing and sneezing
Highly contagious
Most infectious during catarrhal phase before onset of whoop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the stages of pertussis

A

Catarrhal phase
- low grade fever, rhinorrhoea, sneezing
- most infectious
Paroxysmal phase (can last for 10 weeks)
- paroxysms of intense coughing
- coughing can be followed by loud whoop
- infants less than 6 months do not have whoop, at risk of apnoea from exhaustion

Convalescent phase
- chronic cough that may last weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is pertussis always present in the community?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why is there a continued infection risk with pertussis?

A

Infection does not provide lifelong immunity

Vaccination protection lasts about 6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In the early 2000s the pertussis vaccine was cellular. What has replaced this?

A

Acellular vaccine (toxoid)

  • wears off more quickly
  • lower incidence of side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why was there a rise in pertussis cases in the UK?

A

Due to a fall in vaccination coverage because of professional and public anxiety about safety of whole cell vaccine

20
Q

What type of vaccines are diphtheria, tetanus and pertussis?

A

Inactivated toxoid vaccine

21
Q

What causes poliomyelitis?

A

Polio virus - an RNA enterovirus (3 serotypes)

22
Q

How is polio virus transmitted?

A

Faecal oral route

Virus ingested and replication occurs in alimentary tract - replication occurs for long period

23
Q

After the initially alimentary phase of polio, what happens?

A

Virus enters blood stream

In 5% it enters NS across the BBB

24
Q

What are the 3 types of polio infection?

A

Sub clinical in 95% - no or mild coryzal symptoms
Non paralytic - flu like symptoms, headache, fever, myalgia, sore throat
Paralytic - follows non-paralytic symptoms with acute onset paralysis (proximal paralysis more severe than distal)

25
What type of vaccine is the polio vaccine?
Inactivated whole killed virus vaccine | Part of the 6 in 1 vaccine and also 4 in 1 at 3 years 4 months and again at 14 years old
26
Although most children infected with polio virus are asymptomatic, some can develop...
Aseptic meningitis | And less than 1% develop paralytic poliomyelitis
27
Describe the Haemophilus influenza type B organism and how it is transmitted
Gram neg bacteria Opportunistic pathogen that lives in host without causing harm Causes problems when other factors present e.g viral illness Spread through coughing/sneezing/close contact with carrier or infected
28
What, now rare, acute respiratory condition can Hib cause?
Epiglottitis
29
Hib can cause invasive disease primarily in what age group?
Young children (although now rare due to vaccine)
30
What serious infections can Hib cause?
``` Meningitis Sepsis Pneumonia Pericarditis Epiglottitis Septic arthritis Cellulitis Osteomyelitis ```
31
When is Hib vaccine given?
Part of 6 in 1 at 2,3,4 months | Booster dose at 1 year with Men C
32
When is the meningococcal group B vaccine given?
8 weeks 16 weeks 1 year
33
MenB is responsible for what percentage of meningococcal infections in the UK?
90%
34
There are many strains of meningococcal group B bacteria, the Bexsero MenB vaccine protects again almost...of the ones in UK
90%
35
Describe the neisseria meningitidis organism
Gram neg diplococci | 12 capsular groups - BCWY most common in UK
36
Describe the clinical features associated with neisseria meningitidis infection
Prodrome: malaise, fever, vomiting | Headache, neck stiffness, photophobia, drowsiness, confusion, petechial rash (80%)
37
What type of vaccine is MenB?
Inactivated recombinant
38
When is MenC vaccine given?
12 months as Hib/MenC | 14 years as MenACWY
39
What type of vaccine in MenC and MenACWY?
Inactivated conjugate vaccine | Conjugated with tetanus toxoid
40
Describe the rotavirus organism
RNA virus - type A most common | Infection occur via faecal oral route
41
What clinical features are associated with rotavirus ?
Mild fever, severe watery diarrhoea, cramps and vomiting lasting 3-8 days Vomiting often first symptom Can lead to dehydration requiring hospitalisation
42
What type of vaccine is the rotavirus vaccine?
Live attenuated
43
When is the rotavirus vaccine given?
2 months | 3 months
44
When is the MMR vaccine given?
1 year | 3 years 4 months
45
What type of vaccine is the MMR?
Live attenuated