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Occupational Medicine > Occupational Infections > Flashcards

Occupational Infections Flashcards

1
Q

SIDAW

A

Surveillance of infectious diseases at work
Closed in 2015
75% cases due to diarrhoea

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2
Q

ACDP

A

Advisory Committee on Dangerous Pathogens

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3
Q

Public Health Control of Diseases Act 1984

A

Must report notifiable infectious diseases to PH England
30 communicable diseases
Includes HepB, HepC, TB. NOT HIV

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4
Q

Hepatitis B Clinical Features (DNA)

A

Incubation 2-6 months
Acute sx - malaise, fatigue, jaundice, vomiting
30% are asymptomatic
Most patients clear infection spontaneously, 2-10% develop chronic carriage

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5
Q

Anti-HBc +

HBsAg +

A

Current infection or infectious carrier

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6
Q

Anti-HBc +
HBsAg +
HBeAg +

A

Current infection or infectious carrier with particularly high infectivity

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7
Q

Anti-HBc +

HBsAg -

A

Previous infection with natural immunity and non-infectious

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8
Q

Treatment of HBV

A

Interferon alpha, leading to reversal of the carrier state in 40%
Untreated 20-25% of chronic cases infected as adults will get chronic liver disease

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9
Q

Immunization of Hep B

A

Increases level of anti-HBs (surface antibody)
>100IU/L then booster every 5 years
<10IU/L indicates no immunity

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10
Q

Anti-HBc

A

Core antibody

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11
Q

HBsAg

A

Surface antigen

If NEGATIVE can do EPP

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12
Q

HBeAg

A

e antigen

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13
Q

anti-HBs

A

Surface antibody

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14
Q

Workers cannot do EPP if

A

HEP B - Have HBsAg and HBeAg

HEP C - Positive HCV RNA

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15
Q

Acute infection Hep C (RNA)

A

Incubation 6-9 weeks
Mostly asymptomatic. 50% become carriers
At risk of Chronic liver disease and Hep cancer

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16
Q

Anti-HCV

A

HCV antibodies - detectable 3 months after infection

Shows individual was infected but not if active or previous infection

17
Q

Hep C treatment

A

Combination antiviral therapy successful in clearing HCV in 50% of cases.
Pegylated interferon-alpha weekly with ribavirin
There is no vaccine or PEP for HCV.

18
Q

HIV Reporting

A

It is not a PD - can claim as an injury if at work
It is not notificable
It IS reportable to HSE under RIDDOR

19
Q

HCW doing EPP with HIV

A

Can perform EPP if on retroviral therapy and have plasma viral load <200 copies/ml
Need 2 tests 3 months apart
Must remain under OH team

20
Q

AIDS

A

Associated with CD4 <200

Then get pneumocystis, toxoplasma, cryptosporidia

21
Q

HIV Infectivity

A

Measured by HIV RNA

22
Q

PEP in HIV

A

AZT (Zidovudine) is effective in reducing seroconversion following injury
Tx- Truvada and raltegovir
Should be given within 2 hours but can be up to 72 hours

23
Q

TB Vaccination

A

Offered to all Non-immune HCWs

Routine BCG of children aged 11-13 has stopped. Now for at risk, selective vaccination.

24
Q

Pre-employment for HCW - TB

A
  1. Unexplained cough 3 weeks or more in past year
  2. Unexplained weight loss, night sweats, fever
  3. Previous tx for TB or family had tx for TB
  4. Been to a TB country last 12 months?

Check for BCG Scar. May need CR and IGRA

25
Q

IGRA

A

Interferon gamma result. If + indicates latent TB

If negative offer vaccination

26
Q

Hepatits C and EPP

A

Cannot work if anti-HCV positive AND HCV RNA positive

If HCV RNA negative after 12 months and HEP C antibody positive, then can return to EPP

27
Q

Rubella

A

HCW should have immune status checked as risk of transmitting to pregnant ladies.

28
Q

Varicella

A

Non immune HCW should not be in contact with pregnant women, immunocompromised, cancer, transplant and leukaemia patients.

29
Q

MSRA

A

Tx- chlorhexidine mouthwash 5 days, topical mupirocin for 3 days

30
Q

Salmonella Typhi

A

Not to return to work until 6 negative stool samples

31
Q

Shigella

A

3 negative stool samples

32
Q

Streptococcus suis

A

Rare infection of pig farmers, abattoir workers, butchers

PD B9

33
Q

Giardia Intestinalis

A

Protozoan found in normal stools

Outbreaks in sewage workers

34
Q

Hepatitis A

A

Small cluster in nurseries and hospitals

Also risk in sewage workers and farm workers

35
Q

Legionnaires

A

From contaminated condensates from ACs

Pontiac Fever is a mild form of this

36
Q

Hep B and EPP

A

If positive for HBsAg need to be tested for HBeAg
If HBeAg + cannot do EPP
If HBsAg negative, need to check HBV DNA
If HBV DNA>10^3 then can’t do EPP

Occupational Medicine (17 decks)

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