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DTMH Block 4 > Post-exposure prophylaxis > Flashcards

Post-exposure prophylaxis Flashcards

1
Q

Which common viruses can be targeted by PEP?

A

HIV
HAV
HBV
Rabies
VZV
Influenza

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2
Q

Which common bacteria can be targeted by PEP?

A

N. meningitidis
Anthrax
Plague
Pertussis
Tetanus

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3
Q

What is the incubation period of HAV?

A

14-28d

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4
Q

What is the transmission mode of HAV?

A

Fecal-oral

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5
Q

What is the R0 of HAV?

A

3.6

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6
Q

What are preventative measures for HAV?

A

Good sanitation
Food appropriately heated
Avoid food and water in endemic areas
Vaccination

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7
Q

Give examples of HAV contacts

A

Household
Day-care
Workplace of food handlers
Sexual
Illicit drug use

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8
Q

What are the attack rates of HAV in household contacts?

A

15-30%
Higher among children

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9
Q

What is patron risk of HAV if a food handler is infected?

A

Generally low
Risk is higher when food handler has diarrhoea

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10
Q

When can HAV PEP NOT be given?

A

Once secondary cases start to appear -> 2w period of PEP exceeded (incubation)
HCWs (standard IPC)

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11
Q

What are the options for HAV PEP?

A

Single dose vaccine
HAV Ig

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12
Q

Who can receive HAV vaccine?

A

12m-40y
Immunocompetent

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13
Q

Who should receive HAV Ig?

A

<12m
>40y
Immunosuppressed
Chronic liver disease
0.02ml/kg

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14
Q

What is the incubation period of HBV?

A

1-4m

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15
Q

What is the transmission mode of HBV?

A

Blood > body fluids

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16
Q

What is HBV transmission risk if source is HBsAg and HBeAg positive?

A

37-62%

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17
Q

What is HBV transmission risk if source is HBsAg positive and HBeAg negative?

A

23-37%

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18
Q

Which contacts should receive HBV PEP?

A

HCWs
IVDU
Unprotected sex
Neonates

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19
Q

Discuss HBV PEP

A
  1. Wound management (irrigate copiously)
  2. HBsAb <10 or never vaccinated
    - HBV vaccine + HBIG
    Within 24h (up to 7d for sexual)
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20
Q

What percentage of HBV vertical transmission happens intrapartum?

A

99&

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21
Q

What percentage of perinatally acquired HBV results in chronic HBV of the child?

A

90%

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22
Q

How should you manage a mother with HBV?

A

Start TDF in 3rd trimester to drop VL

23
Q

How do you provide HBV PEP for a neonate to prevent vertical transmission?

A

HBV vaccine and HBIG at birth
Vaccine schedule 0/4/8
Monitor longterm for seroconversion

24
Q

What is the incubation period of VZV?

A

14-16d

25
Q

What is the transmission mode of VZV?

A

Droplet
Direct contact with vesicle fluid

26
Q

For how long is a VZV patient infectious?

A

1-2d pre rash until all lesions cruster

27
Q

What is the secondary household attack rate of VZV?

A

> 90%

28
Q

Which VZV contacts should receive PEP?

A

Exposed, susceptible adults and children
5min - 1h exposure face to face contact
Close contact with rash

29
Q

Discuss the varicella vaccine

A

Immunocompetent (live, attenuated vaccine)
Within 3-5d

30
Q

Discuss the varicella immunoglobulin (VariZIG)

A

Within 10d
Immunosuppressed
Pregnant women
Neonates

31
Q

When is influenza PEP indicated?

A

H5N1 avian flu contacts
Immunosuppressed

32
Q

Discuss influenza PEP

A

Oseltamivir 75mg dy
7-10d

33
Q

What is the incubation period of n. meningitidis?

A

2-10d (usually d4)

34
Q

What is the transmission mode of n. meningitidis?

A

Respiratory droplet
Nasopharyngeal colonisation

35
Q

Which groups should receive n. meningitidis vaccine due to high risk?

A

Asplenia
Complement deficiency
Travellers to endemic areas
Military recruits
Microbiologists
Large crows/gatherings
Dormitories

35
Q

What are the PEP options for n.meningitidis?

A
  1. Rifampin
  2. Ciprofloxacin
  3. Ceftriaxone
36
Q

Which n. meningitis contacts require PEP?

A

Prolonged contact >8h while <1m away
Direct contact with secretions

37
Q

Discuss the rifampin dose for meningitis PEP in children >1m

A

10mg/kg/12h x 2d

37
Q

Discuss the rifampin dose for PEP in children <1m

A

5mg/kg/12h x 2d

38
Q

Discuss the ciprofloxacin dose for meningitis PEP in adults

A

500mg single dose

39
Q

Discuss the rifampin dose for meningitis PEP in adults

A

600mg/12h x 2d

40
Q

Discuss the CTX dose for menigitis PEP in children <15y

A

125mg IM single dose

41
Q

Discuss the CTX dose for menigitis PEP in adults

A

250mg IM single dose

42
Q

What is the incubation period of tetanus?

A

2-38d

43
Q

What is the mode of transmission of tetanus?

A

Direct inoculation of spores into tissue

44
Q

What tetanus vaccine options are there?

A

DTap
Tdap
Td

45
Q

When is DTap given in the SA EPI?

A

6w
10w
14w
18m

46
Q

When is Td given in the SA EPI?

A

6y
12y

47
Q

What PEP should a clean and minor wound with <3 previous doses of tetanus toxoid receive?

A

Vaccine

48
Q

What PEP should a clean and minor wound with >3 previous doses of tetanus toxoid receive?

A

Vaccine if last dose >10y ago

49
Q

What PEP should a NON clean and minor wound with <3 previous doses of tetanus toxoid receive?

A

Vaccine
Ig

50
Q

What PEP should a NON clean and minor wound with >3 previous doses of tetanus toxoid receive?

A

Vaccine if last dose >5y ago
No Ig

51
Q
A

DTMH Block 4 (14 decks)

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