Travel/Vaccine Lecture (don't know how much of this we need to know)

Question 1

Which 2 immunizations might be required if you’re traveling?

Answer 1

yellow fever and cholera

Question 2

what type of vaccine is yellow fever

Answer 2

attenuated live virus

Question 3

can you get the yellow virus vaccine anywhere?

Answer 3

no - only at designated centers

Question 4

how long does the yellow fever vaccine give you protection for?

Answer 4

10y

Question 5

where are risk areas for the yellow fever?

Answer 5

equatorial africa, central america, south america

Question 6

how effective is the cholera vaccine?

Answer 6

has limited usefulness

Question 7

how often do you need boosters of the cholera vaccine

Answer 7

every 3 mos

Question 8

if you’re traveling from the US, do you need the cholera vaccine?

Answer 8

no

Question 9

what are the 2 (well, 3) types of cholera vaccines?

Answer 9

inactivated parenteral and “experimental” (inactivated oral or attenuated live oral)

Question 10

what are the downsides of the inactivated parenteral vaccine?

Answer 10

only 50% protection, lasts a few months, uncomfortable side effects

Question 11

how often do you need a tetanus vaccine booster?

Answer 11

every 5y

Question 12

what is the tdap vaccine?

Answer 12

tetanus and diptheria

Question 13

how often do you need a tdap booster?

Answer 13

every 10y

Question 14

which travelers get an MMR vaccine?

Answer 14

those who haven’t had 2 doses or have had a + titer

Question 15

what type of vaccine is the MMR?

Answer 15

live attenuated

Question 16

what should you avoid with the MMR vaccine

Answer 16

gamma globulin (whatever that means)

Question 17

Which countries might you need the inactivated polio vaccine for?

Answer 17

india, nigeria, pakistan, afghanistan and somalia

Question 18

what are the 2 types of polio vaccines?

Answer 18

inactivated parenteral and attenuated live oral

Question 19

who gets the inactivated parenteral polio vaccine?

Answer 19

> 18y who have never been immunized

Question 20

who gets the attenuated live oral polio vaccine?

Answer 20

anyone who needs a booster

Question 21

what risk increases with each dose you get of the polio vaccine?

Answer 21

paralysis

Question 22

what is the dosing for the varicella vaccine?

Answer 22

1 dose before the trip, 1 dose upon returning

Question 23

who gets the pneumovax vaccine?

Answer 23

> 65y with chronic medical conditions

Question 24

Which travelers get the influenza vaccine?

Answer 24

all

Question 25

during what months does the northern hemisphere get the influenza vaccine? southern?

Answer 25

northern is nov to mar. southern is april to sept

Question 26

what are the 2 types of typhoid vaccines?

Answer 26

attenuated live oral or inactivated parenteral

Question 27

how well do the typhoid vaccines work?

Answer 27

both work pretty well (60-70% effective)

Question 28

where is typhoid endemic?

Answer 28

central america, south america, india, africa

Question 29

how is typhoid transmitted?

Answer 29

food and water

Question 30

where is japanese encephalitis endemic?

Answer 30

india, china, korea, japan, SE asia

Question 31

how many shots do you need for the japanese encephalitis vaccine? is there a booster?

Answer 31

3 shots within 1 month. booster at 2 years

Question 32

what are s/e of the japanese encephalitis vaccine?

Answer 32

fever, HA, vom, angioedema, utricaria

Question 33

when should you administer an Hep A vaccine?

Answer 33

almost any traveler, especially peds

Question 34

what is twinrix?

Answer 34

hep a/b vaccine

Question 35

where is hep b endemic?

Answer 35

south america, africa, SE asia, south pacific

Question 36

what are the s/e of the hep b shot?

Answer 36

injection soreness, HA

Question 37

where is rabies endemic?

Answer 37

india, china, SE asia, the philippines, indonesia, latin america, africa, former USSR

Question 38

is there a rabies booster shot for travelers?

Answer 38

no

Question 39

where is meningitis endemic?

Answer 39

sub-saharian africa

Question 40

who is the meningitis vaccine required for?

Answer 40

pilgrims to Mecca

Question 41

is the meningitis vaccine routine for kids?

Answer 41

yes

Question 42

who gets the smallpox vaccine?

Answer 42

military

Question 43

what disease is called by the female anopheles mosquito?

Answer 43

malaria

Question 44

what are the 3 characteristics of the anopheles mosquito?

Answer 44

silent, night-biting, female

Question 45

where is there a highest risk of getting malaria?

Answer 45

africa and oceania

Question 46

how does malaria get into the body and where does it go?

Answer 46

there are sporozoites in mosquito saliva.. travels to the liver and RBCs

Question 47

which type of malaria bug is malignant?

Answer 47

plasmodia falciparum

Question 48

which type of malaria bug has a liver phase?

Answer 48

plasmodia vivax + ovale

Question 49

which type of malaria bug is chronic?

Answer 49

plasmodia malariae

Question 50

what are the sx of malaria?

Answer 50

fever, chills, HA, myalgias, nausea, diarrhea, abd pain, fatigue, confusion

Question 51

what is the timing of the fevers in malaria?

Answer 51

they are cyclic

Question 52

what are the 5 drug options for malaria chemoprophylaxis?

Answer 52

chloroquine, mefloquine, doxycycline, malarone, primaquine

Question 53

where are the high-risk areas for traveler's diarrhea?

Answer 53

central and south america, south asia, africa

Question 54

what most commonly causes traveler's diarrhea?

Answer 54

E. Coli

Question 55

what are the sx of traveler's diarrhea?

Answer 55

abrupt loose stools, abd cramping, rectal emergency

Question 56

what should you look for at foreign restaurants before eating there?

Answer 56

if there are windows and door screens, how they contain the trash, what the restrooms are like, if there are roaches and flies

Question 57

what are the 6 symptomatic treatments for traveler's diarrhea?

Answer 57

diet restrictions, pepto bismol, immodium, lomotil, lactobacillus, and rehydration

Question 58

is there a prophylaxis for traveler's diarrhea?

Answer 58

yeah but you shouldn't really give it. can give 1 dose of an FQ or Rifaximin in case they get sx, but ONLY to be taken if they get sx

Question 59

You should tell your pt to come in for post-travel care if they have what sx?

Answer 59

fever/chills/sweats, weight loss, persistent diarrhea