Vaccine Preventable Diseases Flashcards
T or F: Chikungunya is a bacteria infection
F - viral and spread via infected mosquitos
Where is Chikungunya endemic
Africa, Asia + Americas (excluding Canada, Chile + US), Europe
What is likely going to lead to and increase in Chikungunya infections
climate change: higher T and humidity allow mosquitos to thrive in new areas
Chikungunya infections SS
normally symptomatic + SL
- fever, joint pain
- may get rash, fatigue etc
** joint pain lasts a couple days but arthralgia can last for mths or years
Complications of chikungunya
myocarditis, hepatitis, ocular + neuro conditions —- rare
- virus normally not fatal
Is cholera B or V
Bacterial infection caused by 2 serogroups of Vibrio cholerae
- toxic ones can be found in water + is associated with not good access to clean water
Infections with V. cholera
normally via drinking water with bacteria in it or ingesting contaminated seafood
—- can spread to other via stool (has B in it and can get into water)
T or F: most people with cholera are symptomatic
F- normally asymptomatic
— if symptomatic: watery diarrhea (severe + major water loss —— rapid dehydration and death
Who is recommended to get vaccine against cholera
those who are highest risk of infection
- live in endemic areas (Africa) , HCP in endemic areas
** those travelling in these countries with C have low risk of E
Transmission of COVID 19
Three ways
- aerosol particles (when breathing or talking)
- respiratory droplets (coughing)
- or via touching mucous membranes with hands + then touching others
SARS viruses found in variety of mammals (a lot can move bw animals and humans)
How many novel Coronaviruses have been ID
3
SARs-COV1
MERS-COV: middle east respiratory syndrome
SARS-COV2
What has lead to different variants in COV2 virus
genetic mutations
- some have different manifestations + are affected not always by prior immunity
OG: 4-7 incubation
Omicron: 2-4 incubation
T or F: compared to adults, kids are less likely to be hospitalized, need ICU, or die from COVID
T
— no matter age though: risk increases is smoking, immunocomp, chronic heart/liver/kidney disease, DM, obesity, preg
Estimation of prevention of death with COVID vaccine
14.4 million bw 2020-2021
T or F: you need to have had severe COVID to greet PPC (long covid)
F- can happen in anyone (more common if severe)
- less likely to occur in those who are fully vaccinated
Is Diphtheria caused by B or V
B : Corynebacterium diphtheria
How is C.diphtheria transmitted
person to person via respiratory droplets
SS of diphtheria
affects MM
severe: pharyngeal, tonsillar and laryngeal infections
toxins: causes tissue destruction + pseudomembrane formation
SS: malaise, sore throat, anorexia, fever
—- eventually get blue-white membrane on tonsils ( if get too big : may impact respiration)
— may get edema of neck (bull neck)
Death rate of diphtheria
5-10% with higher rate if under 5 or over 40
Treatment for diphtheria
antitoxin and antibiotic
- antitoxin: binds to unbound toxin to stop progression
- ABX: kill B
—— indicated for close contacts too
Is Ebola caused by a V or B
V
- reservoir not really known (most virulent: fruit bats has EBOV —- responsible for most cases of ebola)
How is EBOV transmitted
transmitted to human via handling or ingesting infected animals (bats and wild game) or via contact with infected blood/bodily fluids/ body tissues or contaminated things
Where is ebola epidemic
Central, West and East Africa
SS of Ebola
Fever, sever headache, diarrhea, vomiting
—— can vomit a lot
may get hemorrhaging from GI (late cases)
Fatality of ebola
25-90% of those infected
- if do survive, have long recovery time + complications
Ebola vaccine in Canada
only available through National emergency strategic stockpile if potential outbreaks or exposure to known cases
— if travelling to area for humanitarian work with high risk —- can get
What ie Enterotoxigenic E. coli
B that causes 25% of acute travellers diarrhea
How it ETEC spread
spread via contaminated food or water (less often)
ETEC vaccination
normally mild and SL
- vaccine only recommended for those with highest risk of infection (endemic areas, HC in these ares)
Hib vs HI
Hib: type of typeable HI
——- responsible for 95% of all HI illnesses
which include meningitis, epiglottitis, pneumonia, arthritis, osteomyelitis, cellulitis
How is Hib spread
respiratory droplets
- colonize nasopharynx of humans
- humans can be reservoir + asymptomatic ( make protective Ab — thought to be reasons for decreased incidence of Hib in kids < 5)
Pre vaccine HiB responsibility for disease rates
50-65% cases of meningitis
permanent hearing or neurological complications in 15-30% of people
- even with treatment 5% died
** still present worldwide by rates low due to vaccination
What is the leading cause of hep A in Canada
travelling
What is Hep A and how is it transmitted
Virus spread via fecal-oral route (contaminated food and beverage)
— shed virus in poop for 2 wks before get onset of SS (virus is viable in environment for weeks)
T or F: Hep A can be spread via blood
T
- F-O more often (common in areas with poor sanitation + limited clean water
T or F: children under 6 are normally asymptomatic
T- normally no symptoms but huge source of infection as they are shedding it
SS of hep A
anorexia, nausea, fever and jaundice
normally lasts 2 mths
Hep A mortality and hospital rate
0.5% death
1/4 need to go to hospital
What is Hep B and how is it transmitted
Virus normally transmitted with mucosal or percutaneous contact with infected bodily fluids (blood, saliva, sexual shit)
- up to 50% of adults and most kids will by asymptomatic
SS of Hep B
first week: non specific (fever, N/V, malaise, skin rash, dark urine)
Icteric phase (1-3 weeks) : jaundice, light stools, hepatic tenderness
— most people get full recovery + production of Ab ensure immunity
Progression rate of Hep B to fulminat Hep B + MR
1-2% get F hep —- mortality rate of 65-90%
— large number of acute cases will progress to chronic (higher MR)
—- 90% of infants will progress to chronic (decrease with age)
—- normally asymptomatic + huge source of infection but risk of chronic hepatitis, liver failure
Estimation of premature death of those with chronic Hep B
25%
Hep B carrier rate in Canada
1%
What is Herpes zoster
virus (HSV) —- causes shingles + chickenpox
primary: causes varicella (painful vesicular eruptions and unilateral dermatome on trunk)
Reactivation: shingles (normally when 50+ + immunocomp)
What is PHN
post herpetic neuralgia associated with herpes zoster virus
— persistent pain at site of rash of up to 3 mths
** no therapies —— vaccines decrease both HZ and PHN
What is the most commonly spread STI
HPV — 75% of sexually active Canadians will have at some point
—— link with HPV and cervical cancer
virus
T or F: infection with one type of HPV gives immunity to other types of HPV
F
Number of HPV associated with cervical cancer
40 types that are associated with different types of cancer
16+ 18 : cause about 70% of all cervical and anal cancers
6+ 11: 90% of genital warts
T or F: most healthy individuals can clear HPV infections
T
small proportion stay infected —— CIN
CIN can resolve by itself but some people with get high grade abnormalities —- cancer precursors
T or F: vaccines for HPV has been shown to decrease risk of getting cervical cancer
T
- benefit is highest in those who are not yet sexually active
Subtypes of flu
4: A, B, C, D
A: classified into further groups based on surface Ag which are related to viruses’ ability to attach + penetrate cells
—— causes moderate to severe cells
Type B: milder disease (mostly in kids)
Type C: only mild
Type D: not known to infect humans
T or F: once you get a flu vaccine, you get immunity going forward
F- minor alterations in virus cause previously acquired immunity not getting complete protection
—— called antigenic drift
How is flu transmitted
respiratory droplets : virus penetrates + replicated in epithelial cells (cell death)
—- follows a seasonal pattern (start late fall and tapering off in early spring)
What is the most commonly severe complication of flu
bacterial pneumonia
Flu hospital rate + death rate
annually: 12, 000 hospital
death: 0.5-1% per 1000 cases (normally those 65+)
Is Japanese Encephalitis caused by B or V
Virus that is closely related to West Nile
— transmitted via infected mosquitos
Reservoirs: pigs + birds
T or F: risk of JE is high in those who travel to endemic areas (Asia)
F- low risk depending on destination, season or nature of travel
Death rate of those who get encephalitis
up to 30% (not all who get JE are symptomatic , 1% will be and get acute encephalitis)
—— mental changes, Parkinson like symptoms
up to 50% survive with problems
Is Measles caused by B or V
Virus + spreads via respiratory droplets
—- get into via nose + then travels to lymph nodes
Measles disease progression
2-3 days after infection: primary viremia occurs
1 wk later: 2nd viremia ( respiratory track and other organs are affected
after incubation period: proximal symptoms for 2-4 days
—— fever, cough + conjunctivitis + Koplik spots on mucous membranes (blue white pathogenic spots)
2-4 days later: maculopapular rash that spreads down face + neck
Complication rate of those who get Measles
1/3 : more likely to occur in those < 5 + older than 20
Measles complication rate: encephalitis
0.1% will get —- 15% of these will die
25% of survivors will have permanent neurological shit
—- will have permanent immunity though
Is Meningococcal disease caused by B or V
B : Neisseria meningitis
— leading cause of BM in Canada ; children < 5 at greatest risk
Transmission of Meningococci
Respiratory droplets from nasopharynx of colonized individuals
— small number of people will have invasion of BS after penetration of nose
— 50% of these bacteremic pts —- meningitis develops
SS of Meningitis
sudden onset of fever, headache, stiff neck, photophobia and altered mental status
Death rate of meningococcemia (Meningococcal sepsis)
in up to 40% of people even with treatment
Sepsis: occurs in 5-20% of people without meningitis
— 20% of survivors will have permanent problems
Is MPox caused by a virus or B
Monkeypox virus (same family as small and cow pox)
- reservoir small mammals in endemic ares of West + Central Africa
How do humans get Mpox
get through a bite or scratch, consuming undercooked meat or via contact with infected animal fluids or lesions
H-H transmission is also possible (direct contact with infected person fluids, mucosal surfaces or skin lesions) OR respiratory droplets
Do we have MPox outbreaks in Canada
Yes: get via infected travellers or infected animals
— since began getting in canada: most transmission via sex ( PH emergency declared in August)
Mpox symptoms
normally SL: 2-4 wks
SS: lesions that are painful, fever, sore throat, rectal pain, fatigue, V, diarrhea
— lesions can appear anywhere on the body
** can experience only skin symptoms, only systemic symptoms or both
Mpox: who are more likely to have complications
preg, immunocomp, or young children
Is measles B or V
V: occurs worldwide and endemic in some areas
- spread via respiratory droplets
Most common complication with mumps in post pubertal men
orchitis: testes inflammation
—- swelling , tenderness etc
sterility is rare
Deafness rate with mumps
1/20,000
Pertussis: cause B or V
B: toxin mediated disease caused by Bordetella pertussis
- pertussis is highly communicable and transmitted via contact with respiratory droplets
incubation : 7 days though can last 3 wks
3 stages of pertussis infection
1) Catarrhal stage: SS like a cold
2) Paroxysmal stage: cough more severe + get coughing fits with thick mucus
- by end normally have long inspirations effort associated with whoop sound
- lasts 2-8 week
3) Gradual decrease in coughing fits (can last wks to mths)
Most common complications with pertussis
Bacterial pneumonia - most common (more likely cause of death)
Does pertussis impact infants or adults more
infants + children
adults: can have it still but normally asymptomatic or mild (reservoir)
Death rate in Canada pertussis
causes 1 to 3 deaths in canada (normally in those under 6 mths)
— immunity after infection is not permanent
Pneumococcal: V or B
B: Strep pneumonia
— 80+ serotypes; most cause disease but only some cause invasive pneumococcal disease (IPD)
— major cause of death worldwide
How is pneumococci spread
person to person via respiratory droplets incubation
- can cause 3 major invasive syndromes: pneumonia, bacteria, and meningitis
MR of pneumococcal pneumonia
5-7%
MR of pneumococci meningitis in kids and adults
K: 8%
A: 22%
Polio: B or V
V with 3 serotypes (infection with one — doesn’t give immunity to other)
transmitted via fecal -oral + highly infectious
T or F: polio virus can impact CNS
T: can replicate in motor neurons and cause cell death
T or F: Canada was deemed polio free in 1994
T
Abortive poliomyelitis
seen in 1/4 of polio infections in kids
- low grade fever, sore throat that resolves in a week
-1-5% will get stiffness of neck and legs etc
Flaccid paralysis and polio
results in less than 1% of polio infections in kids
— loss of reflexes and progressive paralysis
—- MR: 2-5% in kids and 15-30% in adults
What is rabies
acute encephalomyelitis causes by virus (lyssavirus)
- most common transmission via bite by animal with rabies
considered 100% fatal
Who is recommended to get rabies vaccine
travellers depending on duration of stay, activities, availability of post rabies exposure therapy + occurrence of rabies in destination
- if get animal bit: clean right away and should be evaluated for PEP if mammal bite (bat bite —- always indication for PEP)
What is RSV
virus that causes a lot of respiratory illness
transmitted with respiratory droplets, hands or forties
Canada: get outbreaks every year (normally fall to early spring)
Risk of Infants developing serious URTI from RSV
20-30% get pneumonia or bronchitis
Adults: can also get pneumonia, exacerbation of COPD etc
RSV vaccine approached for those 60+ in Canada
What is Rotavirus
Virus caused disease where virus can survive in environment for long tiem
- following oral ingestion: it replications in SI
- a lot are asymptomatic: 1/3 of kids will get D/V + 7% go to hospital
prior infection doesn’t give immunity
PF vaccines shown to decrease incidence of infection + need for hospital
What is Rubella
German measles: caused by a virus
- spread via respiratory droplets
illness normally mild + asymptomatic in 1/2 of people
main SS: rash on face + spread down to feet (may be itchy)
— older people: may have fever + URT SS
Complications of RUbella
Rare + normally happen in adults
- a lot of women have arthralgia and arthritis
Encephalitis: 1/6000
GI hemorrhage: 1/3000 kids
most significant infection: congenital rubella (pregnant lady gets it)
— can pass to baby + can lead to foetal death, abortion or preterm delivery + congenital defects
** if happen in 1st trimester: 85% of infants are infected
What is the primary goal of the rubella vaccination program
to prevent congenital rubella syndrome
What it tetanus + its cause
lockjaw
- caused by toxin made by a bacteria
spores of bacteria found in environment ( germinate when exposed to area with little O2 + make exotoxins)
C. tetanus: most potent toxin to us (normally gets to us via wound)
Death rate of tetanus (industrialized)
10% : most due to prolonged hospital stay not toxin itself
What is typhoid
disease caused by a bacteria ( S. enterica)
—- specifically S. tophi
transmitted via ingestion of fecal contaminated food or water (most people to travel to areas where this is endemic —- low risk of getting)
— highest risk in India, Pakistan + Bangladesh (1/3500)
T or F: Up to 5% of people who are infected with typhi become chronic carriers
T
T or F: most travellers to South Asia should be offered typhoid vaccine
T
What is Varicella
caused by VZV and spread via infected resp droplets + can also be contracted with contact with skin lesions
—- after get: VZV will chill out in nerves and can get reactivated later
chickenpox: rash on head, trunk then extremities
What is yellow fever
disease caused by a virus spread through infected mosquitos
- there are human and non human reservoirs
- blood borne transmission can also occur
endemic to tropical South America + parts of Africa (risk when travelling is low unless in rural area or spending long time there)
- normally disease resolves in couple days
- 15% will have remission of symptoms though that can cause renal failure etc ( death rate of this up to 50% )
