Vaccination Lecture Flashcards
5 DTP
4 Polio
2 MMR
1 Varicella
…vaccinatons required prior to?
Kingergarten (in Maine)
NK cells
PMNs
Complement
Macrophages
Interferon
CRP
..part of?
Innate immunity
The virion consists of a single strand of RNA containing genetic information and a protein coat. Humans are its only natural host.
member of Picornaviruses family
Polio virus
Polio belongs to the ______ subgroup
Enterovirus
3 sero types
Reservoir: humans
Transmission: feces, oro-pharyngeal secretions, droplets
Incubation period: 7-14 days
Polio virus
Paramyxovirus (RNA)
Hemagglutinin important surface antigen
One antigenic type
Rapidly inactivated by heat and light
Measles virus
True or false..
Vaccine preventable diseases are mostly in developing countries?
False
Incubation period 10-12 days (can be as long as 18-21 days)
Prodrome:
Stepwise increase in fever to 103°F or higher
Cough, coryza, conjunctivitis
Koplik spots
Measles
Respiratory transmission of virus
Replication in nasopharynx and regional lymph nodes
Primary viremia 2-3 days after exposure
Secondary viremia 5-7 days after exposure with spread to tissues
Measles
Rash:
Maculopapular rash, usually lasts 5 – 6 days
Begins at the hairline, then involves the face and upper neck
Over next 3 days, moves down and out, reaching hands and feet
Lesions generally separate; may coalesce, particularly on upper body
Initially, lesions blanch with fingertip pressure
Fine peeling over more severely involved areas
Fades in the same order that it appears
Infectious period: 4 days prior to 4 days after rash onset
Measles
Positive serologic test for IgM antibody, OR
Significant rise in antibody level by an standard serologic assay, OR
Isolation of virus from a clinical specimen
Lab criteria for dx of Measles
Vaccination given in 2 doses:
1st dose at 12-15 months
2nd dose 4-6 yo
MMR (measles mumps rubella)
Paramyxovirus rubulaviris
Mumps
Symptoms: swelling of the parotid glands (parotitis), testicular swelling (orchitis) may occur
Complications: some association with infertility in males
Source: respiratory secretions
Incubation period: 14 – 25 days
Infectious period: 6 days before symptoms, 9 days after onset of parotitis
Mumps
Transmission: person-to-person, through respiratory droplets, may also be present in feces and urine
Incubation period: 14 - 21 days
Infectious period: 7 days before - 5 days after symptom onset5,8
Rubella
Togavirus
Rubella
Symptoms: low pyrexia, lymph node swelling, mild pale pink rash
Rash: develops on the face, spreads to the body, can be itchy
Complications: congenital rubella syndrome if a pregnant woman is in contact with the disease in the first 20 weeks of gestation
Source: respiratory secretions
Rubella (Togavirus)
Gram negative aerobic coccobacilli
Slow growth in culture (3-6 days)
Colonizes cilia
Produces several toxins
Causes local necrosis and inflammation
Bordatella Pertussis
Respiratory illness commonly known as whooping cough
Very contagious: 80-90% of susceptible close contacts become infected
Occurs only in humans
Person-to-person spread by infected person coughing or sneezing in close contact with others
Pertussis
Catarrhal :
Watery eyes, low-grade fever, malaise, runny nose, late-phase
nonproductive cough
Paroxysmal:
Paroxysms (bursts of coughing during a single exhalation) followed by an inspiratory “whooping” sound, post-tussive cyanosis, and vomiting
Convalescent :
Paroxysms gradually improve but recur with respiratory infections
Clinical stages of Pertussis
Isolation of organism from clinical specimen
PCR positive
(NO SEROLOGY)
Used for dx of Pertussis
Early antibiotic treatment if identified <21 days after onset
Symptoms may be modified if tx begin early (catarrhal stage)
If begun later, will decrease infectious period but may not decrease duration or severity
Supportive: fluid, rest, cough suppressant, etc.
Hospitalized cases: droplet precautions in separate room until completion of 5d of tx
Treatment and isolation not recommended if >21 days since symptom onset
Pertussis
Case considered infectious for 21 days after onset or until 5 days of abx completed
In general, close contacts are defined as persons who:
Had face-to-face exposure within 3 feet, (includes all household contacts)
Had direct contact w/ respiratory or nasal secretions (cough, sneeze, sharing food/eating utensils, suctioning, etc)
Shared same confined space in close proximity for >1 hour
Pertussis
If symptomatic, treat as a case
If not symptomatic, consider chemoprophylaxis (same dosing regimen as for disease) based on:
Infectiousness of the patient
Intensity of exposure
Potential consequences of severe pertussis in contact
Potential for secondary exposure to persons at high risk (e.g., infants <12 mos, pregnant women)
Tx for Pertussis in those who came in contact with infected pt
Is there a vaccine for Pertussis?
Yes
Universal vaccination of children ages 2, 4, 6, 15-18 mos and 4-6 yrs
DTap (diphtheria tetanus and pertussis)
Neisseria meningitidis colonizes…
nasopharynx
Incubation period 3-4 days (range 2-10 days)
Abrupt onset of fever, meningeal symptoms, hypotension, and rash
Fatality rate 9%-12%; up to 40% in meningococcemia
Meningococcal disease
Bloodstream infection
May occur with or without meningitis
Clinical findings:
fever
petechial/purpuric rash
hypotension
multiorgan failure
Meningococcemia
Bacterial culture
Gram stain
Non culture methods: antigen detection in CSF, serology
Meningococcal labs
All children aged 11-12 yrs, with a booster at age 16 yrs
Other persons 2-55 yrs of age at increased risk
Meningococcal vaccine
Case is considered to be infectious from 7 days prior to symptom onset to 24 hours after initiation of antibiotic treatment
Chemoprophylaxis is recommended for persons who have had close contact with the case’s respiratory secretions within infectious period
Most effective when administered within 24 hours of onset of illness of case-patient
Little value if given more than 14 days after exposure
Post exposure prophylaxis for meningococcal
