Rotavirus, Meningococcal, Measles, Mumps, Rubella, Varicella, Herpes Zoster

Question 1

Rotavirus is caused by…

Answer 1

Viral infection - many serotypes

Question 2

Rotavirus is transmitted via…

Answer 2

Fecal-oral

Question 3

Signs + symptoms of rotavirus include…

Answer 3

diarrhea
Fever, vomiting, stomach pain

Is contagious before individual is ill, and for 24 hours after diarrhea

Question 4

Rotavirus immunization is a…

Answer 4

Live, attenuated oral vaccine (pentavalent, or monovalent)

Question 5

Rotavirus is CI in…

Answer 5

Immunocompromised infants

Question 6

Rotavirus immunizations should be given…

Answer 6

Childhood immunization schedule (3 doses)

Question 7

Can babies eat with the rotavirus vaccine?

Answer 7

Yes - can breastfeed, eat, and drink any time before + after receiving rotavirus vaccine

Question 8

If an infant spits up or regurgitates after rotavirus vaccine, we should…

Answer 8

NOT give a replacement dose

Question 9

After rotavirus vaccine, the virus is shed in stool for _____.

Answer 9

Up to 10 days - caution around immunocompromised household members

Question 10

Rotavirus vaccination does have unique AE’s such as…

Answer 10

Fever, diarrhea, irritability, loss of appetite
Some may have abdominal pain, dermatitis

Question 11

One serious AE from rotavirus vaccination is ____. However…

Answer 11

Bowel obstruction - however, very low absolute risk.

Usually not given if there is history of bowel obstruction

Question 12

Meningococcus is caused by…

Answer 12

Bacterial infection - many serotypes

Question 13

Meningococcus is transmitted via…

Answer 13

Respiratory droplets
Crowded housing = big risk factor

Question 14

Meningococcus causes ____ and ____, which can lead to complications such as…

Answer 14

Meningitis, bacteremia
Can lead to limb amputations, hearing loss, brain damage, seizures, skin scarring…

Question 15

The meningococcal vaccine is…

Answer 15

Inactivated - conjugate vaccine
monovalent (Men-C-C) for 1st dose
Quadrivalent (Men-C-ACWY) for booster

Question 16

Meningococcal immunization should be given…

Answer 16

With childhood immunization schedule (1 dose before 12 months and 1 at grade 6)
Adult = no routine booster unless increased risk of acquiring meningococcal disease (transplant)

Question 17

This type of meningococcus is not routinely vaccinated against, except for…

Answer 17

Serogroup B - only for special populations

Question 18

Measles is caused by…

Answer 18

Viral infection

Question 19

Measles is transmitted via…

Answer 19

Respiratory droplets; highly infectious

Question 20

Signs & symptoms of measles include…

Answer 20

Fever
Sore throat
Cough
Runny nose
Red rash

URTI

Question 21

Complications of measles include…

Answer 21

AOM, pneumonia
Encephalitis
Seizures, deafness, brain damage
Death

Question 22

Mumps is caused by…

Answer 22

Viral infection

Question 23

Mumps is transmitted via…

Answer 23

Respiratory droplets

Question 24

Signs + symptoms of mumps include…

Answer 24

URTI - fever, respiratory symptoms, parotitis

Question 25

Complications of mumps may lead to...

Answer 25

Meningitis, encephalitis Swollen testicles/ovaries Congenital malformations or abortions in pregnancy

Question 26

Rubella is caused by...

Answer 26

Viral infection

Question 27

Rubella is transmitted via...

Answer 27

Respiratory droplets

Question 28

Signs + symptoms of rubella can include...

Answer 28

Flu-like symptoms (rash, lymphadenopathy, arthralgia, fever)

Question 29

Complications of rubella include...

Answer 29

Congenital malformations, miscarriage during pregnancy

Question 30

Varicella is caused by... ## Footnote Varicella = Chicken pox

Answer 30

Viral infection

Question 31

Varicella is transmitted via...

Answer 31

Respiratory droplets Direct contact with blister fluid Vertical transmission (mom to baby)

Question 32

Symptoms of varicella include...

Answer 32

High fever, red itchy rash Rash begins as red spots, that become fluid-filled blisters; eventually crust over

Question 33

Complications of varicella include...

Answer 33

Skin + soft tissue infections Pneumonia Reactivation of virus - herpes zoster/shingles

Question 34

The MMR/V vaccine is a...

Answer 34

Live, attenuated Therefore CI in pregnancy + immunocompromised patients ## Footnote Varicella is available monovalent by itself as well

Question 35

MMRV contains trace amounts of ____ and ____, so we need to be cautious...

Answer 35

Neomycin and gentamicin - cautious in those with severe allergies

Question 36

Efficacy of MMRV vaccine increases with age because...

Answer 36

Maternal antibodies can decrease live vaccine replication + impact efficacy

Question 37

MMR +/- V immunizations should be given...

Answer 37

Childhood immunization series (2 doses) Not routine for adults unless unvaccinated (would have to give MMR and V separately) ## Footnote Most adults will be vaccinated against varicella

Question 38

MMR vaccine AE's include...

Answer 38

Typical injection reactions (soreness, redness, swelling at injection site) Mild subclinical injection occuring 1 week after (malaise, fever +/- rash) Possible joint aches from rubella component RARE occurrences of febrile seizure

Question 39

Varicella vaccine AE's include...

Answer 39

Swelling, redness, low-grade fever Varicella-like rash (blisters) at injection site may develop (less contagious)

Question 40

Herpes zoster is caused by ____

Answer 40

Viral infection - reactivation of varicella zoster virus | AKA Shingles

Question 41

HZV occurs most frequently among...

Answer 41

Older adults, immunocompromised patients Periods of stress

Question 42

Signs + symptoms of HZV include...

Answer 42

Prodromal pain before rash Maculopapular, vesicular rash that is painful and itchy, occurring along 1 or 2 dermatomes that do not cross midline

Question 43

An important complication of HZV is...

Answer 43

Postherpetic neuralgia

Question 44

Shingrix vaccine is a...

Answer 44

Adjuvanted, recombinant

Question 45

If someone has a HZV/shingles episode, we should wait ____ before immunizing with shingrix

Answer 45

Post acute episode (American guidelines) , to 1+ year (NACI)

Question 46

HZV is normally indicated for adults ____, but it could be given to adults 18+ if...

Answer 46

Adults 50+; may be given to adults 18+ immunocompromised and have varicella immunity

Question 47

Shingrix dosing schedule is...

Answer 47

2 doses (0, 2-6 months) | Immunosuppressed = 1-2 months after first