Vaccines

Question 1

Signs of rubella?

Answer 1

Incubation 14 days
Maculopapular , fever, generalized rash
Lymphadenopathy, mild conjunctivities, runny nose, sore throat
asx common

Question 2

What is the treatment for rubella?

Answer 2

Supportive care

Question 3

How many doses of rubella is required to be protected?

Answer 3

1 dose after 1 birthday

Question 4

How is varicella transmitted?

Answer 4

1. Direct contact person to person
2. Inhalation of aerosols from vesicular fluid of skin lesion of varicella or herpes zoster
3. Infected respiratory tract secretions

Enters upper respiratory tract or conjunctiva

Question 5

What is the period of communicability for Varicella?

Answer 5

1-2 days before the rash and ends when all lesions are crusted (4-7 days after onset of rash of immunocompetent)

Isolate for as long the lesions persist

Question 6

Which traveller is at higher risk of Severe varicella?

Answer 6

Infants
Immunocompromised
Pregnant woman without evidence of immunity

Question 7

Clinical presentation of varicella?

Answer 7

Incubatio 14-16
1-2 days of prodromal period (fever, malaise) and pruritic rash: macules, papules, vesicles (250-500 lesions).

> 3 waves resolve with crustinh

Characterize: present of lesions at different stages

Complication is secondary bacterial infections: skin, pneumonia, encephalitis, cerebellar ataxia, hemorrhage

Question 8

How is rubella transmitted?

Answer 8

Person to person or droplets from respiratory secretions

Question 9

Is breakthrough varicella contagious

Answer 9

Yes, not as much

Sx: mild

Question 10

What is the post exposure prophylaxis treatment for measles?

Answer 10

MCV and immune globulin

Administration of the post exposure vaccine within 72 hrs after exposure to measles virus.

IG to prevent or mitigate measles when administered within 6 days of exposure. Person shoould receive MCV 5-6 months after IG

Question 11

JE vaccine should be recommended when?

Answer 11

• long-term traveller (>6 mos ) living in endemic area

- stay> 1 mos during the virus transmission

Question 12

What are the options for children requiring JE protection?

Answer 12

1. Enroll in a clinical trial
2. Off-lable use
   3,. Obtain vaccine at destinatin

Question 13

What are the recommendation for YF vaccine in children/ infants?

Answer 13

1. Never recommended under 6 mos
2. 6-8: vaccinate only if they must travel to epidemic area & high level of insect precaution is not possible

• infants less than 9 mos are at high risk of encephalits from YFV
• less than 9 mos should be advised against traveling to areas within YF endemic zone

Question 14

How should you wait after taking antibiotics before the administration of oral typhoid?

Answer 14

72 hours. Typhoid IM may be more appropriate

Question 15

Can you take chloroquine and malarone concurrently with oral typhoid?

Answer 15

Yes

Question 16

Can chloroquine and rabies ID for preexposure be used concomitantly?

Answer 16

No. Chloroquine can effect antibody response

IM route ok for preexposure rabies

Question 17

Is there any precaution if taking live injectable vaccine and live oral vaccine separately?

Answer 17

Live injectable & oral vaccine are not believed to interfere with each other

Live oral: polio, rotavirus, oral typhoid

Question 18

Spacing of live vaccines when given within 4 weeks after administration of another live vaccine?

Answer 18

Recommendation: if done, 2 vaccine given will afford dome protection but should be readministered 4 wks later if continued risk

Question 19

What is a contra-indication of rotavirus

Answer 19

Latex allergy

Question 20

Precaution of MMRV?

Answer 20

Febrile convulsion 5-12 days after administration

Age: 12 mos to 13 yrs

MMR V: 0 doses- 2 doses MMRV 6 wks apart. Or 2 doses each of mMR and Varicella but 3 months apart