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PHAR358 > Rotavirus, Meningococcal, MMRV, Herpes Zoster > Flashcards

Rotavirus, Meningococcal, MMRV, Herpes Zoster Flashcards

1
Q

What causes rotavirus?

A

viral infection caused by Rotavirus
-many serotypes

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1
Q

How is rotavirus transmitted?

A

fecal-oral

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2
Q

What is rotavirus the most common cause of?

A

most common cause of diarrhea and need for hospitalization for dehydration secondary to diarrhea in children < 5 yrs
-almost all unimmunized children will have at least 1 rotavirus infection by age 5
-can get multiple times but each time is milder (partial immunity)

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3
Q

What are the signs and symptoms of rotavirus?

A

appear 1-3 days after a person has become infected
-diarrhea, fever, vomiting, stomach pain
-diarrhea can last 3-8 days

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4
Q

How long are individuals with rotavirus contagious for?

A

before the individual becomes ill and for 24 hours after diarrhea stops

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5
Q

What kind of vaccine is the rotavirus vaccine?

A

live attenuated oral vaccine

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6
Q

What are contraindications to the rotavirus vaccine?

A

immunocompromised infants
-controversy: CI infants 0-6 months if TNF exposure in utero

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7
Q

How does the rotavirus vaccine come in terms of available products?

A

pentavalent or monovalent

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8
Q

Should children receive the rotavirus vaccine?

A

routine immunization

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9
Q

Can babies eat before or after the rotavirus vaccine?

A

babies can breastfeed, eat and drink any time before or after receiving the rotavirus vaccine

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10
Q

What should be done if an infant spits up or regurgitates after the rotavirus vaccine?

A

a replacement dose should not be administered

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11
Q

What is an important aspect to remember about the first 10 days after receiving the rotavirus vaccine?

A

virus shed in stool for up to 10 days
-caution: handwashing and immunocompromised household members

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12
Q

What are the adverse effects of the rotavirus vaccine?

A

common:
-fever, diarrhea, irritable, loss of appetite, flatulence, abdominal pain, dermatitis
intussusception (bowel obstruction)
-absolute risk is quite low
-if history of bowel obstruction, rotavirus usually not given

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13
Q

What is meningococcus caused by?

A

bacterial infection caused by Neisseria meningitidis
-many serotypes; majority of invasive disease is associated with A, B, C, Y, & W-135

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14
Q

How is meningococcus transmitted?

A

respiratory droplets
close contact with respiratory secretions/saliva
-kissing, sharing of vapes, lipstick, food/drink, toothbrushes
-risk factors: crowded housing

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15
Q

What does meningococcus cause?

A

meningitis and bacteremia (invasive meningococcal disease)
-mostly in children < 5 & 15-24 yrs

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16
Q

What are the complications of meningococcus?

A

limb amputations
hearing loss
brain damage
seizures
skin scarring
even with abx treatment, mortality rate is 10-15%

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17
Q

What are the different types of meningococcal vaccines?

A

Men-C-C = meningococcal conjugate C vaccine
-monovalent
Men-C-ACWY-135 = meningococcal conjugate A, C, Y, W-135 vaccine
-quadrivalent
serogroup B meningococcal vaccines

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18
Q

Which meningococcal vaccines are routine in childhood?

A

Men-C-C and Men-C-ACWY-135
-serogroup B meningococcal vaccines not routine in childhood or adulthood

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19
Q

Which meningococcal vaccines require boosters in adulthood?

A

no routine adult boosters for meningococcal vaccines

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20
Q

Are the two different serogroup B meningococcal vaccines interchangeable?

A

non-interchangeable

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21
Q

Does the MMR vaccine cause autism?

A

does not increase the risk for autism and does not trigger autism in susceptible children

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22
Q

What causes measles?

A

viral infection caused by the measles virus

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23
Q

How is measles transmitted?

A

respiratory droplets
-highly infectious

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24
Q

What is the leading cause of vaccine preventable deaths in children worldwide?

A

measles

25
Q

What are the signs and symptoms of measles?

A

fever
sore throat
cough
runny nose
red rash

26
Q

What are the complications of measles?

A

otitis media
pneumonia
encephalitis
seizures
brain damage
deafness
death

27
Q

What causes rubella?

A

viral infection caused by the rubella virus

28
Q

How is rubella transmitted?

A

respiratory droplets

29
Q

What are the signs and symptoms of rubella?

A

rash
lymphadenopathy
arthralgia
fever

30
Q

What can rubella cause in pregnancy?

A

congenital malformations or miscarriage
-can lead to congenital rubella syndrome in the infant (heart disease, cataracts, deafness)

31
Q

What is varicella caused by?

A

infection caused by varicella zoster virus

32
Q

How is varicella transmitted?

A

respiratory droplets or direct contact with the blister fluid; vertical transmission

33
Q

What are the signs and symptoms of varicella?

A

high fever
red itchy rash (begins at scalp and moves towards trunk)
-begins as red spots that become fluid-filled blisters that gradually crust over

34
Q

What are the complications of varicella?

A

SSTIs
pneumonia

35
Q

What is Herpes Zoster/Shingles?

A

reactivation of the varicella virus

36
Q

What causes mumps?

A

viral infection caused by the mumps virus

37
Q

How is mumps transmitted?

A

respiratory droplets

38
Q

What are the signs and symptoms of mumps?

A

fever
respiratory symptoms
parotitis

39
Q

What are the complications of mumps?

A

meningitis or encephalitis
3/10 males develop swollen testicles
1/20 females develop swollen ovaries
congenital malformations or abortion in pregnancy

40
Q

What kind of vaccine are the MMR/MMRV/V vaccines?

A

live attenuated

41
Q

What are contraindications to MMR/MMRV/V vaccines?

A

pregnancy
immunocompromised

42
Q

When are MMR/MMRV/V vaccines given?

A

deferred until 12 months of age
-maternal antibodies decline at this point

43
Q

What is a potential allergy concern with MMRV vaccine?

A

contains trace amounts of neomycin and gelatin so be cautious in those with severe allergies

44
Q

What is the relationship between efficacy of MMRV vaccines and age?

A

efficacy increases with age

45
Q

Should children receive MMRV vaccines?

A

routine immunization

46
Q

Do adults need MMRV boosters?

A

no routine boosters

47
Q

What are some important considerations regarding MMRV vaccines in adults?

A

MMRV not indicated in adults
-use MMR and V (if required)
V vaccine only indicated to 49 years of age

48
Q

What are common reactions to MMR vaccines?

A

soreness, redness, and swelling at injection site
mild subclinical infection occurring 1 week after
-malaise and fever, w or w/o rash for 3 days
-may occur ~7-12 days after getting the vaccine
possible joint aches from the R component may occur in teenage and adult women

49
Q

What are the adverse effects of V vaccines?

A

swelling and redness, possible low grade fever
a varicella-like rash (blisters) at injection site may develop
-less contagious than virus, cover until dried + crusted

50
Q

What causes herpes zoster?

A

viral infection caused by reactivation of VZV
-VZV causes varicella (chickenpox) –> remains dormant & may reactivate later in life –> herpes zoster (shingles)

51
Q

Can you get herpes zoster if you have never had chicken pox?

A

persons who have neither experienced varicella nor received varicella vaccine are not at risk for herpes zoster

52
Q

What are the signs and symptoms of herpes zoster?

A

prodromal pain can precede the rash by days-weeks
maculopapular vesicular rash occurring along 1-2 dermatomes (usually thoracic) that does not cross midline (unilateral)
-lasts 7-10 days

53
Q

What are the complications of herpes zoster?

A

postherpetic neuralgia
disseminated zoster: ophthalmic, CNS, pulmonary, hepatic
association with increased risk of cerebrovascular events within ~ 1 year post infection
mortality is uncommon
< 10% of individuals 65+ will be hospitalized

54
Q

Who is the Shingrix vaccine recommended for?

A

adults 50 years or older
-also if previously vaccinated with Zostavax II
-zoster/shingles episode
adults 18 years or older with an immunocompromising disease

55
Q

Should the Shingrix vaccine be given in pregnancy?

A

no recommendation, delay until after ideal
breastfeeding: may give, no known risk to infant

56
Q

What kind of vaccine is the Shingrix vaccine?

A

adjuvanted, recombinant subunit

57
Q

Which patient populations were studied in the Shringix RCTs?

A

mean age of 76 years and 62 years

58
Q

What was the comparator in the Shingrix RCTs?

A

placebo

59
Q

How long were the RCTs for Shingrix?

A

~ 3 years

60
Q

What were the outcomes of the Shingrix RCTs?

A

decreased risk of shingles 91%
decreased risk of PHN 90%
immune response maintained for 9 years
-unclear if this correlates with shingles and/or PHN

61
Q

How many doses are required for Shingrix?

A

2 doses (0 then 2-6 months)
-for individuals who are or will be immunosuppressed the 2nd dose can be administered 1-2 months after 1st
*no further doses needed at this time

PHAR358 (20 decks)

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