Vaccinations and childhood infections Flashcards
varicella zoster virus (VZV)
Incubation: 1 to 3 weeks from the time you were exposed to chickenpox for the spots to start appearing.
Tx: aciclovir who presents within 24 hours of rash onset (immunocompromised px only)
Infectious period: from 2 days before the spots appear to until they’ve crusted over, usually 5 days after they first appeared
Notifiable disease
Organism: Rubella virus
Incubation period: 2-3 weeks
Typically a red-pink colour rash. It consists of a number of small spots, which may be slightly itchy.
The rash usually starts behind the ears before spreading around the head and neck. It may then spread to the chest and tummy (the trunk), and legs and arms. In most cases the rash disappears by itself within three to five days.
Enlarged lymph nodes: ears, occiput, neck. In some cases this swelling can be painful.
As well as a rash and swollen lymph glands, people with rubella may also develop other symptoms, including:
a high temperature (fever) – it is usually mild.
cold-like symptoms
slightly sore and red eyes (conjunctivitis)
aching and painful joints
loss of appetite
tiredness
Mx: Advise the person (or their carer) that rubella is usually a mild, self-limiting condition. The rash and fever will typically resolve within 5 days, although swollen lymph glands may take a week or more to improve. Keep the child away from school for four days after the rash appears.
Tx: Rest, drink adequate fluids, and take paracetamol or ibuprofen for symptomatic relief
Haemophilus influenzae
Rare due to Hib vaccine
Presentation: young children, signs of sepsis and inability to swallow or talk.
Refer as examination of throat can precipitate complete airway obstruction
Rotavirus
Rotavirus is the most common cause of diarrhoeal disease among infants and young children.
Transmission: the faecal-oral route.
infect enterocytes of the villi of the small intestine, leading to structural and functional changes of the epithelium.
Human papilloma virus
A group of viruses that affect skin and mucous membranes.
Regions include include:
cervix
anus
mouth and throat
What can HPV infection do?
genital warts – which is the second most common STI in England.
abnormal tissue growth and other changes to cells within your cervix
Girls aged 12-13 are offered a vaccination against HPV to help protect them against types of HPV that can cause cervical cancer.
Other types of HPV infection ; skin warts and verrucas.
MMR
Measles, mumps, and rubella — MMR (MMRVaxPRO® or Priorix®).
Two vaccinations
- at 12 months
- at 3 years and four months
The 6-in-1 vaccine
given at 8, 12 and 16 weeks old.
Which vaccinations are given at 8 weeks?
Which vaccinations are given at 12 weeks?
Which vaccinations are given at 16 weeks?
Which vaccinations are given at one year?
Which vaccinations are given at 3 years and four months?
Whooping cough (pertussis)
Three phases of symptoms
- Catarrhal phase; one week. Dry unproductive cough.
- Paroxysmal phase; can last a month or more; coughing fits, whooping, post-tussive vomiting.
- Convalescent phase - 2 months, gradual improvement.
bacterium: Bordetella pertussis
Spread by droplets during coughing.
Incubation: 7 days
Infectious period 3 weeks after the onset of symptoms.
Notifiable disease
tx: macrolide; erythromycin or clarithromycin
What is the causative agent for croup?
parainfluenza viruses (HPIVs) -80% of cases
can also be RSV, adenoviruses, rhinoviruses, enterviruses, measles
laryngotracheobronchitis (croup), which is a viral disease of the upper airway and is mainly problematic in children aged 6 months to 3 years of age.
Facts about croup
- upper airway infection , 80% cases parainfluenza virus. Other viruses included RSV.
- affects children 6 months to 3 years.
- prevalent in autumn and spring.
Symptoms and management of croup
- Starts with coryzal symptoms, then proceeds to stridor, barking cough, classically worse at night.
- child usually has a hoarse cry.
- usually self-limiting but can be severe. Keep child calm; crying increases oxygen demands.
- Severe: >> respiratory work, cyanosis, drowsiness
tx: control symptoms; paracetomal, NSAIDs
Hospital: oxygen (>94% sats) , systemic dexamethasone and nebulised budesonide (since viral infection)
Lasts typically 3-7 days
Facts about acute epiglottis
causative organism: haemophilus influenzae
rare now due to Hib vaccine.
Signs of sepsis, and an inability to swallow or talk.
Mx: transfer immediately for intubation if suspected.
What is human Respiratory Syncytial Virus (RSV) ?
a syncytial virus that causes respiratory tract infections. (pneumonia)
It is a major cause of lower respiratory tract infections and hospital visits during infancy and childhood
NB> syncytium is a multinucleated cell that can result from multiple cell fusions of uninuclear cells
Facts: acute otitis media
- streptococcus pneumoniae, haemophilus influenzae and viruses
- Symptoms; fever, deafness, pain in the ear.
- Examination; red, inflammed bulging tympanic membrane with loss of light reflex.
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Measles
Incubation period; 10-12 days and infectivity last from four days before, until four days after the rash appears.
coryza, maculopapular rash, fever, cough, conjunctivitis
Koplik’s spots are pathognomonic (They occur in 60-70% of patients during the prodrome and for up to 2-3 days after the rash disappears)
Complications; include otitis media, gastroenteritis, bacterial pneumonia, bronchitis.
Bronchiolitis
- acute lower respiratory tract.
Occurs in very young, most commonly infants between 2 and 6 months old.
Common cause of acute respiratory failure
MCQ late sequalae: possible asthma (although not understood why)
Respiratory syncytial virus (RSV) usually.
>> production of mucus + cell debris + oedema
= narrowing and obstruction of small airways.
Begins as an upper respiratory tract infection (URTI) that evolves with signs of respiratory distress, cough, wheeze, air trapping and bilateral crepitations
NB. widespread fine inspiratory crackles are a key finding
Mx: usually mild, self-limiting. Refer if: poor feeding, respiratory problems
What’s this?
Nematode infection - enterobius vermicularis
Female is larger and may be seen at night emerging from the anus to lay eggs.
The eggs are accompanied by an irritant mucus,; intense pruritus and scratching. Cycle: eggs(anus) - hands - mouth - re-infect.
The presenting feature is often pruritus ani or pruritus vulvae, especially at night.
Tx: hygiene, or Mebendazole (single oral dose)
