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Pharm 228 > Vaccine Preventable Diseases > Flashcards

Vaccine Preventable Diseases Flashcards

1
Q

T or F: Chikungunya is a bacteria infection

A

F - viral and spread via infected mosquitos

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2
Q

Where is Chikungunya endemic

A

Africa, Asia + Americas (excluding Canada, Chile + US), Europe

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3
Q

What is likely going to lead to and increase in Chikungunya infections

A

climate change: higher T and humidity allow mosquitos to thrive in new areas

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4
Q

Chikungunya infections SS

A

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

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5
Q

Complications of chikungunya

A

myocarditis, hepatitis, ocular + neuro conditions —- rare

  • virus normally not fatal
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6
Q

Is cholera B or V

A

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

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7
Q

Infections with V. cholera

A

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)

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8
Q

T or F: most people with cholera are symptomatic

A

F- normally asymptomatic
— if symptomatic: watery diarrhea (severe + major water loss —— rapid dehydration and death

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9
Q

Who is recommended to get vaccine against cholera

A

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

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10
Q

Transmission of COVID 19

A

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)

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11
Q

How many novel Coronaviruses have been ID

A

3
SARs-COV1

MERS-COV: middle east respiratory syndrome

SARS-COV2

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12
Q

What has lead to different variants in COV2 virus

A

genetic mutations
- some have different manifestations + are affected not always by prior immunity

OG: 4-7 incubation
Omicron: 2-4 incubation

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13
Q

T or F: compared to adults, kids are less likely to be hospitalized, need ICU, or die from COVID

A

T

— no matter age though: risk increases is smoking, immunocomp, chronic heart/liver/kidney disease, DM, obesity, preg

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14
Q

Estimation of prevention of death with COVID vaccine

A

14.4 million bw 2020-2021

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15
Q

T or F: you need to have had severe COVID to greet PPC (long covid)

A

F- can happen in anyone (more common if severe)
- less likely to occur in those who are fully vaccinated

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16
Q

Is Diphtheria caused by B or V

A

B : Corynebacterium diphtheria

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17
Q

How is C.diphtheria transmitted

A

person to person via respiratory droplets

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18
Q

SS of diphtheria

A

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)

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19
Q

Death rate of diphtheria

A

5-10% with higher rate if under 5 or over 40

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20
Q

Treatment for diphtheria

A

antitoxin and antibiotic
- antitoxin: binds to unbound toxin to stop progression
- ABX: kill B
—— indicated for close contacts too

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21
Q

Is Ebola caused by a V or B

A

V
- reservoir not really known (most virulent: fruit bats has EBOV —- responsible for most cases of ebola)

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22
Q

How is EBOV transmitted

A

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

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23
Q

Where is ebola epidemic

A

Central, West and East Africa

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24
Q

SS of Ebola

A

Fever, sever headache, diarrhea, vomiting
—— can vomit a lot

may get hemorrhaging from GI (late cases)

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25
Q

Fatality of ebola

A

25-90% of those infected

  • if do survive, have long recovery time + complications
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26
Q

Ebola vaccine in Canada

A

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

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27
Q

What ie Enterotoxigenic E. coli

A

B that causes 25% of acute travellers diarrhea

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28
Q

How it ETEC spread

A

spread via contaminated food or water (less often)

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29
Q

ETEC vaccination

A

normally mild and SL
- vaccine only recommended for those with highest risk of infection (endemic areas, HC in these ares)

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30
Q

Hib vs HI

A

Hib: type of typeable HI
——- responsible for 95% of all HI illnesses
which include meningitis, epiglottitis, pneumonia, arthritis, osteomyelitis, cellulitis

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31
Q

How is Hib spread

A

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)
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32
Q

Pre vaccine HiB responsibility for disease rates

A

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

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33
Q

What is the leading cause of hep A in Canada

A

travelling

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34
Q

What is Hep A and how is it transmitted

A

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)

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35
Q

T or F: Hep A can be spread via blood

A

T

  • F-O more often (common in areas with poor sanitation + limited clean water
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36
Q

T or F: children under 6 are normally asymptomatic

A

T- normally no symptoms but huge source of infection as they are shedding it

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37
Q

SS of hep A

A

anorexia, nausea, fever and jaundice

normally lasts 2 mths

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38
Q

Hep A mortality and hospital rate

A

0.5% death

1/4 need to go to hospital

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39
Q

What is Hep B and how is it transmitted

A

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
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40
Q

SS of Hep B

A

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

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41
Q

Progression rate of Hep B to fulminat Hep B + MR

A

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

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42
Q

Estimation of premature death of those with chronic Hep B

A

25%

43
Q

Hep B carrier rate in Canada

A

1%

44
Q

What is Herpes zoster

A

virus (HSV) —- causes shingles + chickenpox

primary: causes varicella (painful vesicular eruptions and unilateral dermatome on trunk)

Reactivation: shingles (normally when 50+ + immunocomp)

45
Q

What is PHN

A

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

46
Q

What is the most commonly spread STI

A

HPV — 75% of sexually active Canadians will have at some point

—— link with HPV and cervical cancer

virus

47
Q

T or F: infection with one type of HPV gives immunity to other types of HPV

A

F

48
Q

Number of HPV associated with cervical cancer

A

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

49
Q

T or F: most healthy individuals can clear HPV infections

A

T
small proportion stay infected —— CIN

CIN can resolve by itself but some people with get high grade abnormalities —- cancer precursors

50
Q

T or F: vaccines for HPV has been shown to decrease risk of getting cervical cancer

A

T
- benefit is highest in those who are not yet sexually active

51
Q

Subtypes of flu

A

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

52
Q

T or F: once you get a flu vaccine, you get immunity going forward

A

F- minor alterations in virus cause previously acquired immunity not getting complete protection

—— called antigenic drift

53
Q

How is flu transmitted

A

respiratory droplets : virus penetrates + replicated in epithelial cells (cell death)

—- follows a seasonal pattern (start late fall and tapering off in early spring)

54
Q

What is the most commonly severe complication of flu

A

bacterial pneumonia

55
Q

Flu hospital rate + death rate

A

annually: 12, 000 hospital

death: 0.5-1% per 1000 cases (normally those 65+)

56
Q

Is Japanese Encephalitis caused by B or V

A

Virus that is closely related to West Nile

— transmitted via infected mosquitos

Reservoirs: pigs + birds

57
Q

T or F: risk of JE is high in those who travel to endemic areas (Asia)

A

F- low risk depending on destination, season or nature of travel

58
Q

Death rate of those who get encephalitis

A

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

59
Q

Is Measles caused by B or V

A

Virus + spreads via respiratory droplets

—- get into via nose + then travels to lymph nodes

60
Q

Measles disease progression

A

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

61
Q

Complication rate of those who get Measles

A

1/3 : more likely to occur in those < 5 + older than 20

62
Q

Measles complication rate: encephalitis

A

0.1% will get —- 15% of these will die

25% of survivors will have permanent neurological shit

—- will have permanent immunity though

63
Q

Is Meningococcal disease caused by B or V

A

B : Neisseria meningitis
— leading cause of BM in Canada ; children < 5 at greatest risk

64
Q

Transmission of Meningococci

A

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

65
Q

SS of Meningitis

A

sudden onset of fever, headache, stiff neck, photophobia and altered mental status

66
Q

Death rate of meningococcemia (Meningococcal sepsis)

A

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

67
Q

Is MPox caused by a virus or B

A

Monkeypox virus (same family as small and cow pox)

  • reservoir small mammals in endemic ares of West + Central Africa
68
Q

How do humans get Mpox

A

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

69
Q

Do we have MPox outbreaks in Canada

A

Yes: get via infected travellers or infected animals

— since began getting in canada: most transmission via sex ( PH emergency declared in August)

70
Q

Mpox symptoms

A

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

71
Q

Mpox: who are more likely to have complications

A

preg, immunocomp, or young children

72
Q

Is measles B or V

A

V: occurs worldwide and endemic in some areas

  • spread via respiratory droplets
73
Q

Most common complication with mumps in post pubertal men

A

orchitis: testes inflammation

—- swelling , tenderness etc

sterility is rare

74
Q

Deafness rate with mumps

A

1/20,000

75
Q

Pertussis: cause B or V

A

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

76
Q

3 stages of pertussis infection

A

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)

77
Q

Most common complications with pertussis

A

Bacterial pneumonia - most common (more likely cause of death)

78
Q

Does pertussis impact infants or adults more

A

infants + children

adults: can have it still but normally asymptomatic or mild (reservoir)

79
Q

Death rate in Canada pertussis

A

causes 1 to 3 deaths in canada (normally in those under 6 mths)

— immunity after infection is not permanent

80
Q

Pneumococcal: V or B

A

B: Strep pneumonia

— 80+ serotypes; most cause disease but only some cause invasive pneumococcal disease (IPD)

— major cause of death worldwide

81
Q

How is pneumococci spread

A

person to person via respiratory droplets incubation

  • can cause 3 major invasive syndromes: pneumonia, bacteria, and meningitis
82
Q

MR of pneumococcal pneumonia

A

5-7%

83
Q

MR of pneumococci meningitis in kids and adults

A

K: 8%
A: 22%

84
Q

Polio: B or V

A

V with 3 serotypes (infection with one — doesn’t give immunity to other)

transmitted via fecal -oral + highly infectious

85
Q

T or F: polio virus can impact CNS

A

T: can replicate in motor neurons and cause cell death

86
Q

T or F: Canada was deemed polio free in 1994

A

T

87
Q

Abortive poliomyelitis

A

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

88
Q

Flaccid paralysis and polio

A

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

89
Q

What is rabies

A

acute encephalomyelitis causes by virus (lyssavirus)

  • most common transmission via bite by animal with rabies

considered 100% fatal

90
Q

Who is recommended to get rabies vaccine

A

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)
91
Q

What is RSV

A

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)

92
Q

Risk of Infants developing serious URTI from RSV

A

20-30% get pneumonia or bronchitis

Adults: can also get pneumonia, exacerbation of COPD etc

RSV vaccine approached for those 60+ in Canada

93
Q

What is Rotavirus

A

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

94
Q

What is Rubella

A

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

95
Q

Complications of RUbella

A

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

96
Q

What is the primary goal of the rubella vaccination program

A

to prevent congenital rubella syndrome

97
Q

What it tetanus + its cause

A

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)

98
Q

Death rate of tetanus (industrialized)

A

10% : most due to prolonged hospital stay not toxin itself

99
Q

What is typhoid

A

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)

100
Q

T or F: Up to 5% of people who are infected with typhi become chronic carriers

A

T

101
Q

T or F: most travellers to South Asia should be offered typhoid vaccine

A

T

102
Q

What is Varicella

A

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

103
Q

What is yellow fever

A

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% )

Pharm 228 (20 decks)

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