Lecture 11: Infectious Disease Prevention & Immunoprophylaxis Flashcards
What makes an infection a CDC bioterrorism category A?
Requires special action for public health preparedness.
What falls under category A for bioterrorism?
- Anthrax
- Botulism
- Plague
- Smallpox
- Tularemia
- Viral hemorrhagic fevers (lassa, new world, ebola, etc)
PAST BH
What category of bioterrorism is coronavirus?
Category C
What is the causative organism of anthrax and what kind of bacteria is it?
Bacillus Anthracis
G+ rod that forms spores
Soil
How does anthrax present on skin?
Necrotic eschar (BLACK AND PAINLESS)
What kind of systemic S/S does anthrax show?
- Fever
- Fatigue
- Malaise
- N/V
- Cough
- SOB => pneumonia => pleural effusions => death
How is anthrax diagnosed?
- Blood cultures
- Skin lesions
- Resp secretions
- Ig checks
How is anthrax treated?
Antitoxin + Cipro or clinda
How is anthrax treated post exposure/prophylatically?
Vaccination
Cipro
Doxy
Amox
60 days regimen
How can botulism specifically not be transmitted?
Person to person
What is unique about the microbiology of botulism?
Non-living. It is the toxin itself.
Toxin made by clostridium botulinum
What is unique about the antitoxin for botulism?
Although there are 7 subtypes (A-G) of toxins, one antitoxin DOES work on the others.
Did not work on others previously.
Release of what NT is the cause for flaccid paralysis in botulism?
Acetylcholine
How does botulism present?
- Multiple cranial nerve palsies with descending paralysis
- Diplopia, dysphagia, dysarthria, dry mouth, ptosis, dilated pupils, etc.
How is botulism diagnosed?
Toxin immunoassay
How is botulism treated?
Equine antitoxin if early.
Otherwise…
* Intubation, mechanical ventilation, and parenteral nutriton.
* Regeneration of motor neuron synapses (SLOW)
How is botulism prevented?
Cannot.
Vaccine was taken off market.
What is the causative organism in plague?
Yersinia pestis
What are the two main types of plague?
Bubonic
Pneumonic
How does bubonic plague present? How do you get it?
Bite of plague-infected rat flea
- PAINFUL LAN w/ necrosis, fever, bacteremia
- Bubos
- Extensive ecchymosis and necrosis of digits/nose
Ecchymosis resembles frostbite.
How does pneumonic plague present? How is it transmitted?
Inhalation of the bacteria.
- Fever, cough, hemoptysis, and GI Sx
- Pneumonia => pleurals => consolidation => death
- 84% Mortality
How is plague diagnosed?
Blood/bubo/sputum cultures
Antibodies
How is plague treated?
- Gentamicin
- Streptomycin
- doxy
- chloramphenicol
How do you prophylaxis against plague?
- Doxy
- Levofloxacin
What is the causative organism for smallpox?
Variola major virus
What is the pathophysiology of smallpox?
Virus => lymphoid tissue => skin => S/S => face => trunk => vesicles, pustules, scabs, then ulcers.
When is smallpox no longer contagious?
Once all lesions form scabs, similar to chickenpox.
How is smallpox diagnosed?
Culture
PCR
Antibodies
How is smallpox treated?
Isolation.
Supportive.
What is the causative organism of tularemia?
Francisella tularensis
How infectious is tularemia?
Very.
Infected someone examining it in a petri dish.
What is tularemia more commonly known as?
Rabbit fever
Deer fly fever
How does tularemia present?
- Airway inflammation
- Fever, HA, chills, fatigue, malaise
- Conjuctivitis and exanthems possible
- 50% have infiltrates or hilar adenopathy w/o infiltrate
- Visible lymph nodes on upper bronchi
How is tularemia diagnosed?
Gram stain or cultures of infected tissue/blood.
How is tularemia treated?
- Strepto
- Genta
- Doxy
- Cipro
- Chloramphenicol
What is the most widely known viral hemorrhagic fever?
Ebola
What is the structure of the viruses that cause viral hemorrhagic fevers?
Enveloped, single-stranded RNA virus that requires a host.
What are the S/S of a viral hemorrhagic fever?
- Fever
- Malaise
- Prostration
- DIC w/ thrombocytopenia and capillary hemorrhage
What is the suspicion criteria for a viral hemorrhagic fever?
Fever > 38.3C for < 3weeks with 2+ following
* Hemorrhagic or pruritic rash
* Epistaxis
* Hematemesis
* Hemoptysis
* Hematochezia
Serologic testing for antigen and antibody with PCR sent to the CDC.
How is a viral hemorrhagic fever treated?
No approved treatment or vaccine.
Experimental: antibody cocktails and ribavirin
What are universal precautions?
Treat all human body fluid as infected.
What are standard precautions?
Hand hygiene
PPE
What are the main 3 transmission-based precautions we can take?
Contact (gown and gloves)
Droplet (surgical mask w/in 3 ft)
Airborne infection isolation (N95 + negative pressure room)
What are the two types of immunity a vaccine can offer?
Active
Passive
What is active immunity? What gives it?
Induced by vaccines made from bacteria or their products.
What is passive immunity? What gives it?
Administration of preformed antibodies in preparations called immunoglobulins.
Includes antitoxins.