infection in travellers and immunisation

Question 1

what are the 3 CDC travel warning levels

Answer 1

watch Level 1 - practice usual precautions
alert level 2 - practice enhanced precautions
warning level 3 - avoid nonessential travel

Question 2

what is the commonest cause of fatal community acquired pneumonia in the norther territory

Answer 2

melioidosis

Question 3

which additional vaccine would a medical student require if going to work in the norther territory or central australia

Answer 3

hep A

Question 4

what is the commonest and second most common illness in travellors

Answer 4

1. diarrhoea

2. respiratory tract infections

Question 5

what is the most common serious infection in travellors

Answer 5

malaria

Question 6

which is the most common preventable infection in travellors

Answer 6

influenza

Question 7

where is the predominant area for dengue fever

Answer 7

Asia

Question 8

what are the 3 most common modes of disease transmission in travellers

Answer 8

vector borne
respiratory
food and water borne

Question 9

which area of the world has the highest risk of getting a GIT infection if you visit there

Answer 9

south Asia - most of bacterial origin

Question 10

what is the commonest reason for travel in those people who get malaria and why

Answer 10

visiting friends/relatives - because they typically have closer contact with more people

Question 11

what is the most likely age in which you will die from malaria

Answer 11

> 65

Question 12

what are the 8 principles of pre-travel healthcare

Answer 12

• understand the epidemiology of travel
• individualise advice
• start early (>6 weeks)
• allow sufficient time
• identify high risk travellers
• encourage personal responsibility for safe behaviour
• recommend a medical kit
• opportunistic interventions

Question 13

what are the high risk travellers

Answer 13

• chronic illness
• pregnant
• long term, remote, high risk locations
• very young or very old
• travellers visiting friends and relatives

Question 14

what are the applications of immunisation

Answer 14

• prevent infection
• treat infection (rabies)
• prevent or treat non-infectious conditions
• to modify immune responses (desensitization)
• to modify physiological processes (sterilization of animals)

Question 15

what are the 2 types of passive immunisation

Answer 15

antibodies

immune cells

Question 16

what are the uses of passive immunisation with antibodies

Answer 16

treatment and/or prevention of disease

Question 17

sources of antibodies for passive immunisation

Answer 17

human, horse, monoclonal

Question 18

what are the features of passive immunisation with antibodies

Answer 18

• short lived

- potentially hazardous

Question 19

which vaccines use “pooled” immunoglobulin

Answer 19

agammaglobulinaemia
measles
hep A
RSV

Question 20

what are the 5 ways that living vaccines can be made

Answer 20

• unattenuated
• empirically attenuated
• rationally attenuated
• reassortants
• antigen expressed on a living vector

Question 21

what is an unattenuated vaccine

Answer 21

• where the disease is from a different animal - where the disease is from a human but given by a different route

Question 22

what is an empirically attenuated vaccine

Answer 22

a disease that became less virulent for reasons we dont fully understand

Question 23

what is a rationally attenuated vaccine

Answer 23

delete the genes that make it toxic

Question 24

what are 3 vaccines that are living unattenuated vaccines

Answer 24

• respiratory adenovirus (different route)
• rotavirus (different host - monkey, cow)
• vaccinia (BCG vaccine made from bovine BCG originally)

Question 25

which virus vaccines are empirically attenuated

Answer 25

polio (Sabin)
MMR
varicella-zoster
rotavirus
yellow fever

Question 26

which bacterial vaccines are empirically attenuated

Answer 26

BCG

typhoid

Question 27

which vaccines used today are reassortant vaccines

Answer 27

rotavirus

influenza

Question 28

which virus vaccines use inactivated vaccines

Answer 28

polio (Salk)
influenza
hep A
Japanese encephalitis
rabies

Question 29

which bacterial vaccines use inactivated vaccines

Answer 29

cholera
typhoid
pertussis
Q fever

Question 30

which two vaccines for viruses are component vaccines

Answer 30

hep B

HPV

Question 31

which vaccines for bacteria are component vaccines

Answer 31

acellular pertussis

diptheria and tetanus = toxoids

Question 32

advantages of using living vaccines

Answer 32

• broader immune response
• local immunity (sometimes)
• ease of administration

Question 33

what are the disadvantages of using living vaccines

Answer 33

• disease (back mutation, spread, contamination)

- failure (dead, pre-existing immunity, interference)

Question 34

what are the advantages of using killed vaccines

Answer 34

• stable
• contamination unlikely
• cant spread
• safe for immune deficient

Question 35

what are the disadvantages of using killed vaccines

Answer 35

• weaker immune response
• high dose needed
• need adjuvants
• expensive

Question 36

which vaccines can treat the disease

Answer 36

tetanus
diptheria
botulism
gas gangrene

Question 37

which vaccines are able to modify the immune response to a disease if given during the incubation period

Answer 37

measles
RSV
varicella-zoster

Question 38

which vaccines are originally made from horses

Answer 38

diptheria
botulism
gas gangrene

Question 39

how long does the tetanus and diptheria vaccination last for

Answer 39

> 10 years

Question 40

which vaccines show a permanent immune response

Answer 40

measels
mumps
rubella
?HiB
?HPV
?varicella zoster
?TB