Immunizations & Diseases Flashcards
Passive (natural) Immunity
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Short-term immunity; introduces antibodies from another person or animal
Mother to child through placenta or milk
Active (natural) Immunity
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Immune system responds to the presence of antigens during an infection
- Occurs when lymphocytes are activated by antigens during an infection
Artifical Active Immunity
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Dead or attenuated vaccines
Articicial Passive Immunity
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Provides an instant but temporary response (antibodies are not the body’s own so memory cells are not created)
- often used to prevent deadly diseases like tetanus (injection of antitoxins)
When working in a vaccine clinic, what is the name of the important document to give patients with detailed information about the vaccine they will receive?
VIS (vaccine information statement)
Required Vaccine Documentation
- date of administration
- manufacturer
- lot number
- site & route
- name, title, & address of the person giving the vaccine
Inactivated Vaccine
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Microorganism is killed, but will still produce an immune response
Live Vaccine
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Microorganism is alive, but weakened
Toxoid Vaccine
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A toxin has been weakened, but still has an effect antigen
The vaccine targets the toxin produced by the germ (rather than the germ itself)
- Causes the body to produce antibodies to neutralize the TOXIN
- used to protect against tetanus & diphtheria
Recombinant Vaccine
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Genetically altered organism used in a vaccine that will stimulate active immunity
Conjugated Vaccine
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An altered organism is combined with another substance to increase immune response
mRNA Vaccine
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mRNA is injected; the body then creates the genetic code for the viral protein causing the muscle cells to make the viral protein in the body which the immune system can then respond to
Chicken Pox / Varicella
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- Spread by touching lesions, mucus, & saliva - can be airborne through coughing & sneezing.
- Most contagious 1-2 days before rash & shortly after rash
- contact & airborne precautions
- Contagious until all lesions are crusted over
- Macular rash, then papule, then vesicle, then crust
- Have patient wear surgical mask whiel transporting
Signs & Symptoms of Chicken Pox
- mild fever, malaise, ↓ PO intake, abdominal pain, irritability
- macular rash → papule → vesicle → crusted lesion
- up to 500 lesions
- crust remain 1-3 weeks
Chicken Pox Treatment
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- Supportive care (calamine bath, tylenol/motrin for fever)
- IV acyclovir for those who are immunocompromised
Vaccine = varicella
Erythema Infectiosum / Fifth Disease / Human Parvovirus B19
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- Spread through respiratory secretions including mucus & blood; droplet precautions
- Once rash appears, individual is no longer contagious
Defining S/S = lace like rash
- droplet precautions
What is Erythema Infectiosum (fifth disease)?
“Slapped Cheek” caused by human parvovirus B19
- direct & indirect transmission via contact with respiratory secretions & blood
- droplet precautions
- Immunocompromised individuals are at risk
Tx: IVIG for chronic infection in immunocompromised kids; supportive care
No vaccine available
What kind of precautions should be in place for a patient with Erythema Infectiosum (5th disease)?
Droplet precautions
Influenza
A & B strains with subtypes
* spread through droplets & secretions
Complications: pneumonia, OM, athma exacerbations, myocarditis (very rare), febrile seizures, sinusitis
S/S:
* abrupt onset of fever, chills, cough, runny nose, body aches, & ↓ PO intake
Tx: supportive care
* tamiflu (antiviral) for kids with comorbidities - very $$$$$ & GI distress
Vaccine: flu vaccine (yearly)
Measles (Morbillivirus)
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- airborne & contact precautions
- contagious from 4 days before the rash until 4 days after the rash
Prodromal Stage (1-7 days): high fever, malaise, cough, conjunctivitis
* Koplik Spots = 1-3 mm gray/blue, appear on buccal mucosa; last 1-3 days
Stage 2: maculopapular rash (dark red / purple), then an itchy rash on the rash & trunk
TX: supportive care
Vaccine = MMR
What causes measles?
Morbillivirus
What kind of precautions should be in place for a patient with measles?
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contact & airborne
What are the 2 stages of Measles
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Prodromal Stage (1-7 days):
* high fever
* malaise
* cough
* conjunctivitis
* Koplik Spots – 1-3 mm gray/blue, appear on buccal mucosa; last 1-3 days
Stage 2:
* maculopapular rash (dark red/purple)
* then an itchy rash on the rash & trunk
What are koplik spots & what disease are they associated with?
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1-3 mm gray/blue spots that appear on the buccal mucosa & last 1-3 days
- associated with measles
Meningococcus (neisseria meningitidis)
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Know the bold
- Spread by contact with respiratory secretions
- Contagious until appropriate antibiotic has been on board for 24 hours (isolate for 24 hours)
- under 5 years old, & teens / young adults 15-24 years old
- Complications: hearing loss, neuro disability, limb amputation, & scarring
Signs & Symptoms:
* abrupt onset of neck pain / stiffness, headache, fever, malaise, headache, neck pain/stiffness, MS changes
Tx: IV antibiotics with penicillin G, cefotax, ceftriaxone, or ampicillin; watch for septic shock
How long should a child with Meningococcus be isolated for?
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Until the appropriate antibiotic has been on board for 24 hours
How is meningococcus spread?
Know this
Contact with respiratory secretions
What are key signs & symptoms of meningococcus?
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- neck pain / stiffness
- headache
- fever, malaise, vomiting, & MS changes
Mononucleosis / Epstein Barr Virus (EBV)
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Signs & Symptoms:
* fever
* malaise
* headache
* ↓ PO intake
* abdominal pain (spleen)
* sore throat / swollen tonsils
* lymphadenopathy
Tx = supportive care
* lotso f rest
* steroids for swollen tonsils, airway issues / concerns, or splenomegaly
- contagious for up to 3 months after symptoms subside or are even gone
- NO contact sports until spleen is normal size due to risk for abruption
- Complications: peritonsillar abscess, sinusitis, mastoiditis
What are the key signs & symptoms of mononucleosis / epstein barr virus (EBV)?
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- headache
- sore throat / swollen tonsils
- lymphadenopathy
How long can symptoms of epstein barr virus last?
Up to 3 months after symptoms subside or are completely gone
Pertussis / Whooping Cough (Bordatella)
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Spread through inhalation or contact with respiratory secretions
* common with babies & those with medical complications
* May also have apnea, seizures, encephalopathy, & death (nearly 1:100)
STAGES:
* 1.) Catarrhal Stage: URI symptoms, mild cough, fever, lasts 1-2 weeks
* 2.) Paroxysmal Stage: rapid cough & forced inspirations through a narrow glottis. May have cyanosis, vomiting, & extreme fatigue. Infant under 6 months at high risk & may have gagging, gasping, apnea. Also show signs of dehydration due to poor PO intake.
* 3.) Convalescent Stage: 6-10 weeks of coughing
- Isolate 5 days after abx, SPO2 monitoring, coughing spells
What are the 3 stages of Pertusis?
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1.) Catarrhal: URI symptoms, mild cough, fever
* lasts 1-2 weeks
2.) Paroxysmal: rapid cough & forced inspiration through a narrow glottis. May have cyanosis, vomiting, & extreme fatigue.
* infant under 6 months is at high risk & may have gagging, gasping, apnea. Also shows signs of dehydration due to poor PO intake.
3.) Convalescent: 6-10 weeks of coughing
What is the first stage (and the associated signs & symptoms) of Pertussis? How long does it last?
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Catarrhal Stage
- URI symptoms
- mild cough
- fever
*
- lasts 1-2 weeks
What is the second stage (and associated signs & symptoms) of pertussis?
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Paroxysmal Stage
- Rapid cough
- Forced inspiration (through a narrow glottis)
- Cyanosis
- Vomiting
- Extreme fatigue
*
- Infants under 6 months at high risk & may have gagging, gasping, apnea. Also show signs of dehydration due to poor PO intake
What is the third stage (and the associated signs & symptoms) of pertussis? How long does this last?
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Convalescent Stage
- 6-10 weeks of coughing
Treatment for Pertussis
Supportive Care
- suction, keep calm, cool mist humidification
- macrolide antibiotic (azitrhomycin = first choice)
- Vaccine is available
What causes pertussis (whooping cough)?
Bordatella pertussis
