Vaccination, tuberculosis and hepatitis

Question 1

In short, in what ways can vaccines be made?

Answer 1

By weakening the pathogen. Cell culture adaption, creating live vaccines.
By inactivating the pathogen. The pathogen is killed.
By using a part of the pathogen. Recombinant techniques.
By using inactivated toxins.
By using polysaccharides from the pathogen.
By conjugating polysaccharides from the pathogen and a help protein.

Question 2

What are examples of attenuated/live vaccines?

Answer 2

MMR, BCG and chickenpox vaccines.

Question 3

What are examples of vaccines using part of the pathogen?

Answer 3

HPV and hepatitis B vaccines.

Question 4

What are examples of toxoid vaccines?

Answer 4

Tetanus, pertussis and diphtheria vaccines.

Question 5

What are examples of conjugated vaccines?

Answer 5

Pneumococcal, meningococcal and Hib vaccines.

Question 6

What diseases were eliminated by the introduction of the HiB vaccine in Norway in 1992?

Answer 6

HiB meningitis and epiglottitis.

Question 7

How large is the percentage of the world’s population infected with tuberculosis?

Answer 7

33 %.

Question 8

When exposed how likely is it for an individual to be infected with tuberculosis? How likely will it at become a latent infection?

Answer 8

The likelihood of infection is up to 30 %. In 90 % of cases the infection becomes latent and may develop into active disease later in life.

Question 9

What are common symptoms of tuberculosis in small children? What symptom(s) never occur?

Answer 9

Common symptoms are fever, chronic cough, dyspnea, and failure to thrive.
Hemoptysis never occurs.

Question 10

What are common symptoms of tuberculosis in older children?

Answer 10

Common symptoms are chronic and/or productive cough.

Question 11

What are the main differences in children with tuberculosis compared to adults?

Answer 11

Due to an immature immune system the development from latent to active disease can be affected. The incubation time is short compared to adults, and extra-pulmonar disease is more common.

Question 12

Associated with tuberculosis, what is a x-ray most likely to show in an infection in a small child and in an infection in an older child/adult?

Answer 12

Small child: Hilary lymphadenopathy.

Older child/adult: Cavitating lung disease.

Question 13

What are advantages of IGRA-test compared to mantoux?

Answer 13

IGRA-test is more specific, has no reaction to BCG or atypical mycobacteria and is more sensitive in immunosuppresion.

Question 14

What is the standard treatment for tuberculosis?

Answer 14

The first 2 months: Rifampicin, isoniazid, pyrazinamide and ethambutol.
The next 4 months: Rifampicin and isoniazid.

Question 15

When is tuberculosis prophylaxis indicated?

Answer 15

If a child/adolescent is < 18 years of age and
originally from a high prevalence region they
should receive TB prophylaxis.

Question 16

What are common symptoms of hepatitis B in small children and in older children?

Answer 16

There are few symptoms in small children.

Older children often have flu-like symptoms, fatigue, joint pain and pain in the abdomen.

Question 17

How is hepatitis A, B and C transmitted?

Answer 17

HAV: Fecal-oral transmission.
HBC: Vertical transmission (perinatal). Horizontal (blood and other body fluids).
HCV: Vertically and horizontally through blood.

Question 18

True or false: In 90 % of cases maternal HBV infection is transmitted to the child during pregnancy, but performing a c-section can help reduce the risk of transmission.

Answer 18

False. C-section does not protect from vertical transmission.

Question 19

Does the risk of chronic HBV carriage increase or decrease relating to the age at infection?

Answer 19

The risk of chronic HBV infection decreased with age at infection.

Question 20

How large is the risk of a HCV-PCR positive mother transmitting the disease to her child during birth?

Answer 20

4-7 %.