infection in travellers and immunisation

Question 1

what are the 3 CDC travel warning levels

Answer 1

watch Level 1 - practice usual precautions
alert level 2 - practice enhanced precautions
warning level 3 - avoid nonessential travel

Question 2

what is the commonest cause of fatal community acquired pneumonia in the norther territory

Answer 2

melioidosis

Question 3

which additional vaccine would a medical student require if going to work in the norther territory or central australia

Answer 3

hep A

Question 4

what is the commonest and second most common illness in travellors

Answer 4

1. diarrhoea

2. respiratory tract infections

Question 5

what is the most common serious infection in travellors

Answer 5

malaria

Question 6

which is the most common preventable infection in travellors

Answer 6

influenza

Question 7

where is the predominant area for dengue fever

Answer 7

Asia

Question 8

what are the 3 most common modes of disease transmission in travellers

Answer 8

vector borne
respiratory
food and water borne

Question 9

which area of the world has the highest risk of getting a GIT infection if you visit there

Answer 9

south Asia - most of bacterial origin

Question 10

what is the commonest reason for travel in those people who get malaria and why

Answer 10

visiting friends/relatives - because they typically have closer contact with more people

Question 11

what is the most likely age in which you will die from malaria

Answer 11

> 65

Question 12

what are the 8 principles of pre-travel healthcare

Answer 12

• understand the epidemiology of travel
• individualise advice
• start early (>6 weeks)
• allow sufficient time
• identify high risk travellers
• encourage personal responsibility for safe behaviour
• recommend a medical kit
• opportunistic interventions

Question 13

what are the high risk travellers

Answer 13

• chronic illness
• pregnant
• long term, remote, high risk locations
• very young or very old
• travellers visiting friends and relatives

Question 14

what are the applications of immunisation

Answer 14

• prevent infection
• treat infection (rabies)
• prevent or treat non-infectious conditions
• to modify immune responses (desensitization)
• to modify physiological processes (sterilization of animals)

Question 15

what are the 2 types of passive immunisation

Answer 15

antibodies

immune cells

Question 16

what are the uses of passive immunisation with antibodies

Answer 16

treatment and/or prevention of disease

Question 17

sources of antibodies for passive immunisation

Answer 17

human, horse, monoclonal

Question 18

what are the features of passive immunisation with antibodies

Answer 18

• short lived

- potentially hazardous

Question 19

which vaccines use “pooled” immunoglobulin

Answer 19

agammaglobulinaemia
measles
hep A
RSV

Question 20

what are the 5 ways that living vaccines can be made

Answer 20

• unattenuated
• empirically attenuated
• rationally attenuated
• reassortants
• antigen expressed on a living vector

Question 21

what is an unattenuated vaccine

Answer 21

• where the disease is from a different animal - where the disease is from a human but given by a different route

Question 22

what is an empirically attenuated vaccine

Answer 22

a disease that became less virulent for reasons we dont fully understand

Question 23

what is a rationally attenuated vaccine

Answer 23

delete the genes that make it toxic

Question 24

what are 3 vaccines that are living unattenuated vaccines

Answer 24

• respiratory adenovirus (different route)
• rotavirus (different host - monkey, cow)
• vaccinia (BCG vaccine made from bovine BCG originally)

Question 25

which virus vaccines are empirically attenuated

Answer 25

``` polio (Sabin) MMR varicella-zoster rotavirus yellow fever ```

Question 26

which bacterial vaccines are empirically attenuated

Answer 26

BCG | typhoid

Question 27

which vaccines used today are reassortant vaccines

Answer 27

rotavirus | influenza

Question 28

which virus vaccines use inactivated vaccines

Answer 28

``` polio (Salk) influenza hep A Japanese encephalitis rabies ```

Question 29

which bacterial vaccines use inactivated vaccines

Answer 29

cholera typhoid pertussis Q fever

Question 30

which two vaccines for viruses are component vaccines

Answer 30

hep B | HPV

Question 31

which vaccines for bacteria are component vaccines

Answer 31

acellular pertussis | diptheria and tetanus = toxoids

Question 32

advantages of using living vaccines

Answer 32

- broader immune response - local immunity (sometimes) - ease of administration

Question 33

what are the disadvantages of using living vaccines

Answer 33

- disease (back mutation, spread, contamination) | - failure (dead, pre-existing immunity, interference)

Question 34

what are the advantages of using killed vaccines

Answer 34

- stable - contamination unlikely - cant spread - safe for immune deficient

Question 35

what are the disadvantages of using killed vaccines

Answer 35

- weaker immune response - high dose needed - need adjuvants - expensive

Question 36

which vaccines can treat the disease

Answer 36

tetanus diptheria botulism gas gangrene

Question 37

which vaccines are able to modify the immune response to a disease if given during the incubation period

Answer 37

measles RSV varicella-zoster

Question 38

which vaccines are originally made from horses

Answer 38

diptheria botulism gas gangrene

Question 39

how long does the tetanus and diptheria vaccination last for

Answer 39

>10 years

Question 40

which vaccines show a permanent immune response

Answer 40

``` measels mumps rubella ?HiB ?HPV ?varicella zoster ?TB ```