notifiable diseases and immunisations

Question 1

what us a notifiable disease?

Answer 1

• Diseases, infections and conditions specifically listed as
  notifiable under the Public Health (Infectious Diseases)
  Regulations 1988
• Legal obligation for any doctor that suspects a case to inform
  the Proper Officer of the Local Authority

Question 2

you have to wait for lab confirmation before notifying PHE of a pt with a notifiable disease T or F?

Answer 2

F - don’t have to wait or lab confirmation

Question 3

give examples of a notifiable disease

Answer 3

acute meningitis 
acute polimyelitis 
cholera 
diptheria 
enteric fever 
haemolytic uraemic syndrome 
leprosy
malaria 
measles 
mumps 
rubella 
SARS 
whooping cough 
TB
infectious bloody diarrhoea 
Leginnaires

Question 4

why are some diseases notifiable?

Answer 4

very severe diseases
vaccine preventable diseases
diseases that need specific control measures

Question 5

Why is it important to notify PHE about these diseases?

Answer 5

we can detect changes in a disease ie new outbreaks and can give early warning o people in the surrounding areas, staff and can predict spread
we can track changes in a disease - has the disease got any more severe, are more people getting affected and what are the risk factors

Question 6

How do you notify PHE of a disease?

Answer 6

fill in a form on the GOV website

Question 7

how can we protect the community from notifiable diseases?

Answer 7

investigate - ie contact tracing
identify and protect vulnerable people - ie isolation, immunisation and chemoprophylaxis
exclude high risk people from high risk settings
Educate, inform, raise awareness, health promotion
Coordinate multi-agency responses

Question 8

give examples of diseases to which maternal antibodies are passed onto the foetus

Answer 8

measles

pertussis

Question 9

what diseases do we have methods of passive immunisation against?

Answer 9

tetanus, hepatitis B, rabies and
varicella zoster
measles
hepatitis A.

Question 10

how is passive immunity obtained?

Answer 10

by injection of human immunoglobulin - Human normal immunoglobulin (HNIG) derived from the pooled plasma of
donors and contains antibodies

Question 11

what can vaccines be made from?

Answer 11

inactivated - ie dead pathogens 
attenuated life organisms 
secreted products eg toxins 
constituents of cell walls/ subunits 
recombinant proteins

Question 12

which vaccines are killed/inactivated?

Answer 12

pertussis, inactivated polio

Question 13

which vaccines are attenuated live?

Answer 13

yellow fever, MMR, polio, BCG

Question 14

which vaccines contain secreted products?

Answer 14

tetanus, diphtheria toxoids

Question 15

which vaccines contain the constituents of cell walls?

Answer 15

Hep B

Question 16

what are the disadvantages of polysaccaride vaccines?

Answer 16

not as immunogenic as protein antigens.
Protection is not long-lasting
Response in infants and young children often poor.

Question 17

Do live attenuated vaccines work quickly?

Answer 17

no - the live attenuated organism must replicate in the vaccinated individual to produce an immune response and this takes time ie days or weeks

Question 18

what is primary vaccine failure?

Answer 18

person doesn’t develop immunity from the vaccine

Question 19

what is secondary vaccine failure?

Answer 19

person develops immunity from the vaccine but this protection wanes over time to below the protective level

Question 20

in what two ways can meningococal infection present?

Answer 20

meningitis or septicaemia

Question 21

what bacterium causes meningococcal infection?

Answer 21

Neisseria meningitidis

Question 22

how is meningiococcal infection spread?

Answer 22

Transmitted from person to person by inhaling
respiratory secretions from the mouth and throat or
by direct contact (kissing)
close prolonged contact is required as it does not live long outside the body

Question 23

at what age do the majority of infections occur of meniniococcal disease?

Answer 23

under 1 is the peak incidence

the majority of infections occurs in children less than 5

Question 24

At what age on the second peak of incidence for meningococcal infection?

Answer 24

young adults -15-19

Question 25

is there seasonal variation with meningococcal infection?

Answer 25

yes in winter there are most cases

Question 26

how are the pathogenic groups of N. meningitidis classified?

Answer 26

done according to the polysaccharide outer capsule and this splits them into serogroups - B, C, A, Y and W135

Question 27

is there a vaccine for N. meningitidis?

Answer 27

yes

Question 28

what are the sequelae of N. meningitidis infection?

Answer 28

o Brain abscess
• Brain damage
• Seizure disorders
• Hearing impairment
• Focal neurological disorders
• Organ failure
• Gangrene
• Auto-amputation
• Death

Question 29

why does gangrene and auto-amuputation occur with N. meningitidis?

Answer 29

as Meningococcaemia causes arterial occlusions

Question 30

what is the clinical management of N. meningitidis infection?

Answer 30

Antibiotic therapy: Cefotaxime or Ceftriaxone

Supportive treatment

Question 31

what would you do if there was a case of suspected meningitis?

Answer 31

all cases of suspected meningitis are notifiable and must be notified without delay

Question 32

what is a contact defined as in meningitis?

Answer 32

a person who has had close contact with a case in the past 7 days

Question 33

what does close contact mean?

Answer 33

kissing
sleeping together
>8 hours in the same room

Question 34

are the cases of meningitis infectious before the onset of symptoms?

Answer 34

yes there is an infectious period before the onset of symptoms

Question 35

what does the incubation period consist of?

Answer 35

the latent period (ie no symptoms and not infectious) and the infectious period (no symptoms and infectious)

Question 36

what forms of prophylaxis are there for contacts who have been exposed to sb with meningitis?

Answer 36

advice - warn them about symptoms and signs, glass test and contact phone number
antibiotic chemoprophylaxis - ie ciprofloxacin or rifampicin
immunisation -

Question 37

is there a meningitis vaccine for travel?

Answer 37

yes - eg for the meningitis belt and other countries which have epidemics