vaccines, foodborne illnesses Flashcards
what is the likely natural reservoir of ebola?
unknown but maybe bats
how is ebola transmitted?
from person to person through direct contact with ebola infected blood or body fluids (urine, saliva, feces, vomit, semen)
what must a patient have in order to spread ebola?
symptoms!
what does contract tracing consist of?
it is a standard public health procedure immediately employed to identify and monitor those who may have potentially been exposed to a sick patient (interviewing, constructing maps, assessing risks)
how do we treat ebola?
provide IV fluids, balance electrolytes, maintain O2 status
what must you ensure when dealing with your PPE should you become exposed with someone with an infectious disease?
remove the MOST contaminated PPE first
what are the most common causes of death in international travel?
#1 cardiovascular #2 medical #3 injury #4 homicide/suicide #5 infectious disease (1/100,000 travelers will die)
which two vaccines may be REQUIRED for international travel?
yellow fever, cholera
how long does the yellow fever vaccine remain effective for? where are areas of risk?
10 years! equatorial africa, central, and south america are high risk
which disease has a new circulating serotype for which vaccine has not been developed?
vibrio cholera 0139; affects indian subcontinent and asia
what does the CDC recommend for vaccination for cholera?
one injection meets international requirements; full series of 3 shots for some patients
boosters may be required every 6 months
how often should the tetanus (Tdap or Td) booster be given?
every 10 years unless puncture wound over 5 years past last booster
who should receive the polio vaccine? do we give a booster?
- should be used in patients over 18
- small risk in paralysis with first dose (1/1.4 million)
- single booster for travel to india, nigeria, pakistan, somalia
who gets pneumovax?
- over the age of 65
- anyone with chronic medical conditions
where is typhoid endemic? who should get the vaccine?
people traveling to central and south america, india, africa
food and water born illness
who should receive the vaccine for japanese encephalitis?
people engaging in outdoor activities (particularly rice and pig farming) and traveling over 1 month in rural areas far east (india, china, korea, japan, SE asia)
given in 3 doses with booster every 2 years
where are hepatitis A and B endemic?
hep A: nearly all international locations
hep B: south america, africa, SE asia, south pacific
how are hepatitis A and B vaccines given?
hep A: >4 weeks, booster at 6 months and 12 months
hep B: 0, 1, 6 months
how is the rabies vaccine given?
series 0, 7, 21, or 28 days if exposure
who gets the meningococcal vaccine?
pilgrims to mecca
meningitis is endemic in sub-saharan africa
who is the smallpox vaccine indicated for?
military
what mosquito causes malaria?
FEMALE anopheles mosquito
what do the female anopheles mosquitos typically carry? which is the more concerning protozoal parasite it can carry?
typical: plasmodium vivax, ovale, malariae
BAD: plasmodium falciparum
prevalence of malaria?
300 million cases with 3 million deaths annually
how is malaria transmitted?
1) mosquito bites and injects malaria
2) goes to your liver to form merozoites
3) becomes sporozoites in RBC
4) break apart your RBC and symptoms begin
which two species of malaria can remain dormant in the liver? why is this bad?
P. ovale and P. vivax
they can still transmit disease when dormant! make sure to treat for P. ovale and P. vivax no matter what
complications of malaria?
DIC, splenic rupture, anemia
DOC for malaria prophylaxis?
depends on geography!!
for pharm purposes: chloroquine
how can we protect against acquiring malaria?
DEET, permethrin, appropriate clothing, screens
most common pathogen in traveller’s diarrhea?
e. coli (50 percent)
fecally contaminated food and water
which two pathogens capable of causing traveller’s diarrhea are most infectious?
shigella and giardia
- only require 10-100 organisms
- shigella less common
symptoms of traveller’s diarrhea?
abrupt onset of loose stools, abdominal cramping, rectal urgency
usually self-limited
risk factors for developing traveller’s diarrhea?
immunosuppressed, inflammatory bowel disease, H2 blockers, PPIs, antacids
treatment of traveller’s diarrhea?
fluoroquinolones (short course, 3 days)
FLUID!
is prophylaxis indicated for traveller’s diarrhea?
NO. just avoid street vendors, buffets, raw or undercooked meats/seafood, raw fruits/veggies, tap water, unpasteurized dairy products
what is a long-term sequelae that could develop due to food-borne infection with e. coli?
hemolytic uremic syndrome (2-5 percent)
long term kidney dysfunction
what is a long-term sequelae that could develop due to food-borne infection with campylobacter jejuni?
guillane barre syndrome (1 out of 1000)
which organisms are responsible for possible reactive arthropathy as a long-term sequelae?
salmonella, campylobacter, yersinia enterocolitica, SHIGELLA
1-3 percent of infections
what is the most common cause of food-related illness?
NOROVIRUS
while we have seen significant drops in e. coli, campylobacter, salmonella…what have we seen a significant increase in?
VIBRIO! 85% increase
why may we be seeing an increase in foodborne vibrio infections in the US?
associated with eating raw shellfish from WARM WATERS; increasing because our sewage is sent into our oceans and now oceans are warmer because of CLIMATE CHANGE
characterized by a large number of cases in ONE jurisdiction, detected by affected group themselves, and involves a local investigation, local food handling error, and local solution
focal outbreak
characterized by a small number of cases in many jurisdictions, detected by LAB-based subtype surveillance, and involves multi-state investigation, industrial contamination event, and broad implications
dispersed outbreak
most common food related to outbreaks?
poultry!
leafy greens #2, dairy #3, beef #4
what is beginning to emerge as an important problem in regards to foodborne illness?
drug-resistant salmonellosis (typhimurium, newport)
still sensitive to cipro, bactrim but these diseases cause more severe and longer illness
all have dairy cattle as reservoir and are transmitted through GROUND BEEF
which formulation of e.coli can cause hemolytic anemia (enterohemorrhagic e. coli)?
shiga-toxin producing E. coli 0157 serogroup (STEC)
how long does norovirus typically last?
24-48 hours
individual may be contagious for at least 2 weeks post recovery
how is norovirus transmitted?
person-to-person
extremely contagious
fecal-oral route
kitchen workers can contaminate food
symptoms of norovirus?
nausea, vomiting, diarrhea (NOT bloody), abdominal cramping, LOW grade fever if present
