infection in travellers and immunisation Flashcards
what are the 3 CDC travel warning levels
watch Level 1 - practice usual precautions
alert level 2 - practice enhanced precautions
warning level 3 - avoid nonessential travel
what is the commonest cause of fatal community acquired pneumonia in the norther territory
melioidosis
which additional vaccine would a medical student require if going to work in the norther territory or central australia
hep A
what is the commonest and second most common illness in travellors
- diarrhoea
2. respiratory tract infections
what is the most common serious infection in travellors
malaria
which is the most common preventable infection in travellors
influenza
where is the predominant area for dengue fever
Asia
what are the 3 most common modes of disease transmission in travellers
vector borne
respiratory
food and water borne
which area of the world has the highest risk of getting a GIT infection if you visit there
south Asia - most of bacterial origin
what is the commonest reason for travel in those people who get malaria and why
visiting friends/relatives - because they typically have closer contact with more people
what is the most likely age in which you will die from malaria
> 65
what are the 8 principles of pre-travel healthcare
- 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
what are the high risk travellers
- chronic illness
- pregnant
- long term, remote, high risk locations
- very young or very old
- travellers visiting friends and relatives
what are the applications of immunisation
- prevent infection
- treat infection (rabies)
- prevent or treat non-infectious conditions
- to modify immune responses (desensitization)
- to modify physiological processes (sterilization of animals)
what are the 2 types of passive immunisation
antibodies
immune cells
what are the uses of passive immunisation with antibodies
treatment and/or prevention of disease
sources of antibodies for passive immunisation
human, horse, monoclonal
what are the features of passive immunisation with antibodies
- short lived
- potentially hazardous
which vaccines use “pooled” immunoglobulin
agammaglobulinaemia
measles
hep A
RSV
what are the 5 ways that living vaccines can be made
- unattenuated
- empirically attenuated
- rationally attenuated
- reassortants
- antigen expressed on a living vector
what is an unattenuated vaccine
- where the disease is from a different animal - where the disease is from a human but given by a different route
what is an empirically attenuated vaccine
a disease that became less virulent for reasons we dont fully understand
what is a rationally attenuated vaccine
delete the genes that make it toxic
what are 3 vaccines that are living unattenuated vaccines
- respiratory adenovirus (different route)
- rotavirus (different host - monkey, cow)
- vaccinia (BCG vaccine made from bovine BCG originally)
which virus vaccines are empirically attenuated
polio (Sabin) MMR varicella-zoster rotavirus yellow fever
which bacterial vaccines are empirically attenuated
BCG
typhoid
which vaccines used today are reassortant vaccines
rotavirus
influenza
which virus vaccines use inactivated vaccines
polio (Salk) influenza hep A Japanese encephalitis rabies
which bacterial vaccines use inactivated vaccines
cholera
typhoid
pertussis
Q fever
which two vaccines for viruses are component vaccines
hep B
HPV
which vaccines for bacteria are component vaccines
acellular pertussis
diptheria and tetanus = toxoids
advantages of using living vaccines
- broader immune response
- local immunity (sometimes)
- ease of administration
what are the disadvantages of using living vaccines
- disease (back mutation, spread, contamination)
- failure (dead, pre-existing immunity, interference)
what are the advantages of using killed vaccines
- stable
- contamination unlikely
- cant spread
- safe for immune deficient
what are the disadvantages of using killed vaccines
- weaker immune response
- high dose needed
- need adjuvants
- expensive
which vaccines can treat the disease
tetanus
diptheria
botulism
gas gangrene
which vaccines are able to modify the immune response to a disease if given during the incubation period
measles
RSV
varicella-zoster
which vaccines are originally made from horses
diptheria
botulism
gas gangrene
how long does the tetanus and diptheria vaccination last for
> 10 years
which vaccines show a permanent immune response
measels mumps rubella ?HiB ?HPV ?varicella zoster ?TB
