6 Childhood viral vaccinations

Question 1

Which viral infections are notifiable diseases? (6).

Answer 1

Acute meningitis.
Acute poliomyelitis.
Measles.
Mumps.
Rubella.
Smallpox.

Question 2

Which virus causes measles?
Transmission?
Infectivity?
Incubation?

Answer 2

Paramyxovirus.
Droplet.
4 days before rash to 4 days after.
7-18 days

Question 3

Clinical features of measles. (5).

Type of rash?

Answer 3

Rash + fever + cough/ coryza/ conjuctivitis.

Erythematous, maculopapular, head to trunk. Koplik’s spots (white, inside cheek) 1-2 days before rash.

Question 4

Complications of measles. (5).

Answer 4

Otitis media.
Pneumonia. 
Diarrhoea. 
Acute Encephalitis.
Subacute sclerosing panencephalitis- fatal 7-30yrs after.

Question 5

How is measles diagnosed?
Treated?
Prevented?

Answer 5

Clinical, leukopenia, oral fluid sample, serology.
Supportive + ?antibiotics.
MMR vaccine live 1yr/preschool.

Question 6

Which virus causes chickenpox?
Transmission?
Infectivity?
Incubation?

Answer 6

Varicella zoster.
Droplet.
2 days before rash until vesicles dry.
14-15 days

Question 7

Clinical features of chickenpox. (3).

Type of rash?

Answer 7

Fever, malaise, anorexia.

Centripetal rash. Macular > papular > vesicle > pustular.

Question 8

Complications of VZV? (6).

Answer 8

Pneumonitis. 
CNS involvement. 
Thrombocytopenia purpora. 
Foetal varicella zoster syndrome. 
Congenital varicella. 
Shingles.

Question 9

How is chickenpox diagnosed?

Treated?

Answer 9

Clinical. PCR.

Symptomatic adults and immunocompromised children. Acyclovir. Chlorpheniramine to relieve itch.

Question 10

How is VZV prevented?

Answer 10

Vaccine - 2 live doses.
VZV immunoglobulin if significant exposure, immunocompromised/ pregnant/ neonate + no antibodies. Reduces infection or severity.

Question 11

Which virus causes rubella?
Transmission?
Infectivity?
Incubation?

Answer 11

Togavirus.
Droplet.
1 week before rash, 4 days after.
14-21 days.

Question 12

Clinical features of rubella.

Type of rash?

Answer 12

50% are asymptomatic.
Post auricular and sub occipital lymphadenopathy.
Transient and erythematous rash behind ears and on face/neck.

Question 13

Complications of rubella? (3).

Answer 13

Thrombocytopenia.
Post infectious encephalitis.
Arthritis.

Question 14

Effect of rubella in pregnancy? (7).

Answer 14

Congenital rubella syndrome.

Cataracts, deafness, abnormal heart, microcephaly, growth retardation, inflammatory lesions in organs.

Question 15

Transmission risk of rubella in pregnancy?

Answer 15

Under 11 weeks: 90%
11-16 weeks: 20%
16-20 weeks: minimal risk, deafness only
20 weeks: no increased risk.

Question 16

How is rubella diagnosed and treated?

Answer 16

IgM/G detectable from rash.
No Rx.
Immunoglobulin if pregnant.
Vaccine in MMR.

Question 17

Clinical features of Parovirus B19? (6).

Answer 17

Minor respiratory. 
Slapped cheek. 
Arthralgia. 
Aplastic anaemia. 
Prolonged anaemia in immunocompromised.

Question 18

How is parvovirus B19 diagnosed and treated?

Answer 18

Serology IgM/G.

None. No vaccine.

Question 19

When is parvovirus B19 infectious?

Answer 19

Before the onset of rash.

Question 20

Enteroviral infections. Transmission route?
Symptoms?
Worst complication?

Answer 20

Facial oral or contact.
Fever and rashes.
Meningitis.

Question 21

What does respiratory syncytial virus cause?
How is it diagnosed?
What is the Rx?

Answer 21

Bronchiolitis in under 1’s.
PCR form aspirate.
O2, manage fever and fluid intake.

Question 22

What does metapneumovirus cause? Dx? Rx?

Answer 22

Respiratory illness (possible pneumonia).
PCR.
Supportive only.

Question 23

What does adenovirus cause? (3).
Dx?
Rx?

Answer 23

Mild URTI, conjunctivitis, diarrhoea (40/41 subtypes).
Respiratory/eye swab PCR.
Cidofovir in immunocompromised.

Question 24

What does parainfluenza cause? (3).
Transmission?
Dx?

Answer 24

Crops, bronchiolitis, URTI.
Droplet.
PCR.

Question 25

What does rhinovirus cause?

Answer 25

The common cold. | Mound in 70% of mild URTI symptoms.

Question 26

``` Rotavirus: transmission? Incubation? Features? Rx? Prevention? ```

Answer 26

``` Facial oral, occ respiratory. 1-2 days. D+V. Rehydration. Oral live vaccine at 2+3months. ```

Question 27

How is norovirus spread? Incidence of vomiting? course of illness?

Answer 27

Foodbourne, person to person. >50%. 12-60 hours.

Question 28

How is mumps spread? Infectivity? Incubation?

Answer 28

Direct, droplet, fomites. Days before parotid swelling and after. 2-4 weeks.

Question 29

How does mumps usually progress?

Answer 29

Nonspecific prodrome. 24hrs - earache, tenderness over ipsilateral parotid. 2-3 days - enlarging and painful parotid. Pyrexia up to 40oC. Rapid resolution.

Question 30

What are rare manifestations of mumps? (5).

Answer 30

``` Sialadenitis. Oophoritis. Meningitis. Encephalitis. Pancreatitis. ```

Question 31

How is mumps diagnosed?

Answer 31

Clinically. | Raised serum amylase. Normal WCC.

Question 32

What does toxoplasma cause congenitally? (2).

Answer 32

Chorioretinitis, hydrocephaly.

Question 33

What are the most common extra-salivary manifestations of mumps? (2).

Answer 33

Epidiymo-orchitis. | CNS.