Infections w/Vaccines Flashcards
What organism causes measles & mumps?
RNA paramyxovirus
HIGHLY infectious
What is the pattern of Sx in someone with measles?
1) 2-3d = prodrome
2) 5-7d = Exanthematous stage
3) 14d = rash
What is the incubation period for Measles, Mumps, Rubella, Chicken Pox & Whooping cough?
Measles = 10d Mumps = 14-21d Rubella = 14-21d Chicken = 10-20d Whooping = 7-20d
What Sx occur in the prodromal stage of measles?
Fever + Cough + Coryza
Conjunctivitis
Koplick spots
What Sx occur in the exanthematous stage of measles?
Maculopapular rash:
Behind ears → face → trunk
Lasts 6-8days
OTHER: Lymphadenopathy, anorexia, diarrhoea
How is measles investigated?
Blood Film: Leucopaenia
Bloods: LFTs (↑AST/ALT), IgM↑
Sputum sample + PCR: Measles RNA
How is measles treated?
Supportive: Isolation, Fluids, nutrition, paracetamol
2o bacterial infection: Amoxicillin
Severe: Ribavirin
What are the complications of measles?
Acute OM
Pneumonia- immediately after infection
Encephalitis- 7d after usually if immunoS
Sub-acute sclerosing panencephalitis- 7-13yrs post
What organs does mumps affect?
MAINLY salivary glands
Pancreas
Testis/ovary
Brain
How long is mumps contagious for?
7d before swelling
9d after parotid swelling
How does mumps present?
Fever + malaise + myalgia
PAROTITIS: painful, earache, pain on eating, dry mouth
How is mumps treated?
Symptomatic
What are the complications of mumps?
Orchitis = INFERTILITY
Hearing Loss
Acute pancreatitis
Meningitis
What are the Sx of orchitis (as a complication of mumps)?
Chills/sweats Headache Backache Swinging fever Severe local testicular pain & tenderness Swollen scrotum
What organism causes Rubella?
RNA Togavirus
When is Rubella infective?
5days before + 5days after rash
What are the Sx of Rubella?
Low grade fever
Macular rash: Discrete on face → coalesce whole body
Forcheimer spots: Red spots on palate
Lymphadenopathy: Post-auricular, sub-occipital, cervical
Arthralgia
How is Rubella investigated?
Serology +/- Saliva PCR
FBC: ↓WCC
How is Rubella managed?
Supportive
ASK about contact w/pregnant women
What are the complications or Rubella?
Foetal damage: Teratogenic in 1st trimester = Miscarriage/Stillbirth not thought to be a risk >20w
Encephalopathy
Arthritis + Arthralgia
Thrombocytopenia
When is chicken pox infective?
2d before vesicles till last vesicle has crusted over
How does Chicken Pox present?
Viral Prodrome: Fever + Coryza 2days before rash
Vesicular rash
Itchy++
Headache, anorexia, URTI
How does the Chicken Pox rash progress?
Head + trunk → body
Macules → Papules → Vesicle → Pustule → Crust
How is Chicken Pox investigated?
Clinical diagnosis but if unsure:
Serology: VZV IgM
How is Chicken Pox treated?
Isolation/off school
Supportive: Calpol/Paracetamol, Calamine lotion
Severe/immunoS: Aciclovir
2o bacterial: Flucloxacillin
What are the indications for a varicella zoster vaccine?
In contact w/people at high risk of severe chicken pox/shingles infection
-Non-immune healthcare workers
What are the complications of chicken pox?
Secondary bacterial infection Necrotising fasciitis & TSS Viral pneumonia/Pneumonitis Encephalitis Shingles
What should be done if a pregnant women comes into contact with someone with chicken pox?
Prev had chicken pox: No worries
Not prev had chicken pox: Antibody blood test → not immune → varicella zoster immunoglobulins
How does shingles occur?
VZV reactivation later in life
Vesicular lesions in nerve distribution
How does shingles present?
Burning rash follows dermatome
Tx: Aciclovir 10mg/kg TDS
What organism causes whooping cough?
Bordetella Pertussis
Commonly co-infected w/RSV
What are the Sx of whooping cough?
CATARRHAL PHASE: (1-2w) -Coryza + cough + fever PAROXYSMAL PHASE: (2-6w) -Paroxysmal coughing fit & inspiratory whoop leads to vomiting Rhinorrhoea Subconjunctival haemorrhage Young: Apnoea & NO WHOOPING
In whooping cough what makes the cough +/- vomiting worse?
Night
Post-feeds
How is whooping cough investigated?
PCR via nasal swab = DIAGNOSTIC
Culture
Bloods: ↑WCC, leucocytosis
Serology: If >17yo or <5yo w/2w cough for anti-pertussis toxin IgG
How is whooping cough treated?
Self-limiting usually 1m
Erythromycin 14d or Clarithromycin 7d
Isolation: For 5d after starting Abx
Prophylaxis: Immunisation & Erythromycin to close contacts
What are the complications of whooping cough?
Encephalitis & seizures
Dehydration
Weight loss
What are the indications for hospital admission w/whooping cough?
<6mo Ventilation required Apnoea Cyanosis Severe paroxysms Seizure
