MMR Flashcards
Are MMR vaccines part of the National Childhood Immunisation Schedule?
Yes
Do MMR vaccines confer life-long immunity?
Yes
What virus types are MMR?
Measles and Mumps are -ssRNA
Rubella is +ssRNA
What are the symptoms of a Measles infection?
1) Fever, conjunctivitis, rhinorrhoea, cough
2) Koplik’s spots (arnd parotid duct orifices → rash onset
3) Maculopapular rash (from face to entire body)
4) Temporary/transient skin hypopigmentation
What are the possible complications of a Measles infection?
1) mucosal infections (conjunctivitis, otitis media)
2) Respi (eg. broncho pneumonia, giant cell pneumonia)
3) Diarrhoea
4) Encephalitis
5) Sub-acute sclerosing panencephalitis (develops long after apparent recovery)
What is the pathology of a Measles infection?
Viraemia (replication) in respiratory epithelium → spread thru blood and lymphatics → skin (rash)
What kind of virus is Measles?
Paramyxovirus (-ssRNA) w an envelope
How is Measles spread?
Aerosol
Is Measles highly contagious?
Yes
How is Measles infection diagnosed?
1) Grow virus from pharynx, conjunctiva or urine on monkey kidney cells (will form multinucleated giant cells)
2) RT-PCR
3) Serology (IgM recent, IgG past)
What type of vaccine is the MMR vaccine?
Live attenutated
When is the MMR vaccine contraindictated?
Malnourished, immunocompromised children and pregnant women
What do you do with a immunodeficient person who has had close contact with someone with Measles?
Passive immunisation w immune IgG
What type of virus is Mumps?
Paramyxovirus (-ssRNA) with envelope
What are the symptoms of Mumps infection?
1) Salivary gland enlargement (esp. parotid) + pain aggravated by eating
2) Fever, malaise
3) Tender cervical lymphadenopathy
How is Mumps transmitted?
Respiratory droplets
What are some typical complications of Mumps infection?
1) Aseptic meningitis (common but mild)
2) Orchiditis (usually unilateral and can cause infertility)
3) Pancreatitis (10%)
How is Mumps diagnosed?
Specimen from: Saliva, Throat washings, urine, CSF
1) RT-PCR
2) Culture with hen eggs
(CPE → rounding of cells, multinucleated syncytial formation and eosinophilic inclusions)
3) Serology
What type of virus is Rubella?
Rubivirus (+ssRNA) w envelope
Why do people only get Rubella once in their life?
There is only 1 serotype
How is Rubella transmitted?
Respiratory droplets
What type of side effects do MMR vaccines cause?
Mild pyrexia
(only rare lymphadenopathy, arthralgia, arthritis, or polyneuropathy)
What anti-virals should you use for MMR infections?
None available :(
What is the pathology of Mumps?
It replicated in URT → spreads via blood (to parotid gland, gonads, pancreas, meninges)
What are the symptoms of Rubella infection?
1) Forschheimer’s spots
(rose spot on palate → herald rash)
2) German measles/typical rubella rash (maculopapular rash)
- early lesions discrete → coalesce
3) Constitutional symptoms
(eg. fever, headache, malaise, conjunctivitis)
4) Tender lymphadenopathy
(eg. suboccipital, postauricular, cervical nodes)
What are the possible complications of a Rubella infection?
1) Arthralgia and arthritis
(when rash subsides)
2) Encephalitis
3) Purpura and Petechiae (thrombocytopaenia)
4) Congenital Rubella Syndrome
- teratogenic in 1st semester
- ↑defect in organogenesis
- still births/spontaneous abortion
- Birth defects
(eg. Ocular lesions, Sensorineural deafness, CNS, CVS, Interstitial Pneumonitis, Type 1 DM, Hepatosplenomegaly, Thrombocytopenia, Metaphyseal osteitis)
How is a Rubella infection diagnosed?
No culture → time consuming
1) Serology (eg. IgM or TRCHES IgG panel)
How do you prevent the spread of Rubella?
1) Herd immunity
2) Quarantine
3) Screen pregnant mothers antenatally for Rubella Abs
4) Prophylactic IgG early after exposure
