Lecture 28

Question 1

Taking a history

Answer 1

Up to date

• need to know schedule, age they were immunisted
• where they were born - overseas, if there was an outbreak at that time

Question 2

Measles

Answer 2

• highly infectious
• red dots, also can have rash on their inner lip
• can get secondary infections quite commonly
• Need two doses

Question 3

Meningitis

Answer 3

• swelling around brain
• rapidly evolving rash
• can become so necrotic that they fall off
• nisseria meningitidis, can also be caused by s.pneumonia, and hameophilus influenza type b - all have a sugar coating capsule around them - poor immunological memory to polysaccharide antigens

Question 4

Conjugate vaccines

Answer 4

Young infants produce a very weak antibody repsonse to polyaccharide antigens
-poor immunological memory to polysaccharide antigens

• take the sugar coating, and conjugating it to somethign
• so it becomes an immune stimulant
• this is taken up by B cells
• carrier protein digested and antigen is presented to the helper T cells
• converts a t cell independent carb antigen to a t cell depednent antigen
• good immunogenicity i those less than 2
• produces memory cells

-good for haemophilus influenzae type b

Question 5

Hib Vaccine

Answer 5

• induces antibody to PRP capsule and protects against invasive disease
• effective in young infants, reduces or eliminates nasopharyngeal colonisation
• given at 6 weeks, 3 months, 5 months and 15 months

Question 6

Streptococcus pneumoniae

Answer 6

• Gram positive cocus
• polysaccharide external capsule
• many differnt types of capsule - and this plays an essential role in ecape from phagocytosis
• can get into cerebrospinal fluid (cause meningitis), blood, or plueral space/lung tissue
• children -die from pneumococcal disease
• can develop otitis media

Question 7

When do we give streptococcus pneumoniae vaccine?

Answer 7

• contains capsular polysaccharide from each of the common ifecting strains
• used when someone has a poor immuen system, has splenoctomy, or chornic illness
• for eldery and children younger than 2 years

this is also given at 6 weeks, 3 months, 5 months and 15 months ??

• or people with poor immune system
• reduces pnemonia, and otitis media

Question 8

Neisseria meningitidis

Answer 8

• also has very virulent capsule
• is transmitted by droplets from colonized upper resp muscosal membranes
• many different serotypes
• most caused by A, B,C
• antibodies play major role in protection
• polysaccharide capusle, is composed of sugars that are found on the surface of human immature neural cells
• so lymphoctes that could produce antibodies to the capsule are detected during fetal development
• the MenzB vaccine - is produced agains the two outer membrane proteins (Por A and Por B)
• antibodies to these can cause complemetn activation and phagocytosis

Question 9

Side effects

Answer 9

No increase in rates of autism ect, and need to encorage children to be vaccinated