Flashcards in Comm Disease Deck (33):
1
Risk factors for STEC
Animal/farm environment
Raw milk
Produce - leafy greens
Untreated water/rec water
Travel
2
Restriction for case/contact STEC
High risk cases clearance (2x negative stool)
High risk contacts 1x negative stool
3
Enterics - high risk groups
Food prep workers
Staff/patients in healthcare/residential/ECE
Children <5 at ECE
Others at high risk of spreading infection due to illness/diability
4
Risk factors for legionella
Longbeachae - soil
Pneumophilia - warm water (cooling towers, spas)
No person to person spread (ie no contact)
5
Risk factors for yersinia
Contaminated food - pork, unpasturised milk, fruit and vege, tofu
Contaminated water, infected animals
Person to person does occur
6
Risk factors for Hep A
Contaminated food (raw/undercooked seafood, produce such as berries, lettuce)
Contaminated water
Infected food handler
Travel
7
Restriction for Hep A case
Exclusion for 1 week from onset of jaundice/symptoms
8
Definition of Hep A contact
2 weeks pre and 1 week post jaundice onset
All household contacts, staff and kids at ECE
9
Hep A contact managment
Offer vaccine within 2 weeks of last contact
Offer immunoglobulin for those who vaccine is contraindicated (eg <1 year)
10
R0 and period of communicabiltiy for pertussis
R0=14
No treatment - 3 weeks post onset of cough
Effective ABs - 2 days post starting abs
Other ABs - 5 days post startig
11
Treatment of pertussis
Antibiotics only alter course of illness during early stages; however does reduce infectivity by eradicating organism from secretions
12
Restriction of pertussis case
Exclude form school, ECE, work until received 5 days of ABs
13
High risk pertussis contacts
Children <12 months
Kids/adults who live/work with <12 month olds
Pregnant women
Immunocompromised
14
What is the goal of contact management in pertussis?
Protect infants, pregnant women and peopel at risk of complications
15
Management of high risk contacts in pertussis
Give prophylaxis, but not necessary to exclude if asymptomatic. Offer vaccine if not likely immune
16
Other control measures for pertussis
Immunisation during pregnancy, every pregnancy (28-38 weeks). On time imms for infants. Encourage close family contacts of infants to have booster (booster every 10 years for LMCs, ECE workers, WCTO workers)
17
Exclusion for mumps
5 days post swelling onset
18
Definition of susceptible contact mumps
Close (<1m) contact 2 days pre and 5 days post parotitis
Born after 1981 and not fully vaccinated
19
Exlclusion for mumps contacts
Consider exclusion of susceptible contact with no MMR form uni/school/ECE/work for 25 days post last exposure - can be readmitted after first dose of MMR
- those with 1 dose should be offered 2nd dose and then can return
The goal of this is to increase overall immunity and limit spread, whilst minimising disruption from secondary infection
20
Clinical description of measles
Generalised maculopapular rash - starting on the head and neck
Fever at time of rash
Cough or coryza or conjunctivitis present at rash onset
21
Why do we care about measles?
Infectious
10% of complications such as otitis media, pneumonia, croup
1 in 1000 encephalitis
22
Measles period of communicailtiy
5 days pre to 5 days post rash
23
Definition of contact measles
Susceptible contact
Confined space with case during communicability, person in waiting room or consult room with case or 1 hour after is considered a contact
- born after 1969 and not fully vaccinated
- Born 69-81 who only received single dose of measles
**If in doubt vaccinated (no undue effects of vaccinating someone who's already immune)
24
Restriction for susceptible measles contacts
14 days after last contact with case
If given 2nd dose of MMR can return
MOsH may decide not to exclude if 1st dose of MMR given within 72 hours and returning to setting where unimmune have been excluded and person is monitored for signs and symptoms
25
Other control measures for measles
2 doses of MMR
Encourage ECEs to keep vaccination records
Practices and labs understanding importance of isolation of suspected cases
26
Case management meningococcal
Must be given AB that eliminate carriage pre hospital discharge
27
Definition of contacts meningococcal
Anyone with close contact 7 days pre and 24 hours post ABs - overnight household, HCW with unprotected contact, ambulance, kissing, others at discretion
28
Treatment of meningococcal contact
Prophylaxis - given ASAP (<24hours) Purpose is to eradicate nasopharyngeal colonization ad therefor prevent transmission to others
Immunization - if case is group A, C, W, Y (if group B currently only for multi-occupancy residential outbreak emergency supplies)
29
Counselling for meningococcal contacts
Prophylaxis doesn't treat incubating disease. See Dr if symptoms develop.
30
Risk factors for typhoid/paratyphoid
Shellfish from sewage contaminated water
International - shellfish, raw fruit and vege, milk/milk products
Travel
31
Restriction for typhoid cases
High risk - 3 consecutive negative stool
2-5% may become carriers - risk assessment ? alternative work ? treatment (d/w ID)
32
Restriction of typhoid contacts
High risk - exclude until 2 x negative samples
Not high risk - collect sample, exclusion not required
33