Vaccinations and Vaccine Preventable Diseases Flashcards Preview

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Flashcards in Vaccinations and Vaccine Preventable Diseases Deck (29):
1

Original Method of Vaccination

variolation

2

Introduced Variolation to Colonies

Reverent Cotton Mather

3

Discovered cowpox vaccine to protect against smallpox 

Edward Jenner

4

Passive vs. Active Immunity

  • Passive (no B or T-cell short term immunity)
    • infant covered by maternal or IV administered immunoglobulin
    • IVIg, Hep B, tenanus, rabies

 

  • Active
    • naturally occurring d/t contact w/ disease (variable response and long term effect)
    • vaccine induced

5

Vaccine Types

  • live attenuated (weakened) viruses
  • inactive/killed viruses
  • recombinants
  • reassortments
  • immunologic bacterial components
  • toxoids

6

Live Attenuated Virus Vaccines

  • measles, mumps, rubella
  • varicella
  • nasal influenza

7

Inactivated/Killed Virus Vaccines

  • polio
  • Hep A
  • injected influenza

8

Recombinant Vaccines

use a piece of the germ that stimulates immune response

  • Hep B - HBsAg protein inserted into yeast
  • HPV - particles synthesized from recombinant HPV proteins
  • shingles - varicella glycoprotein with adjuvant

9

Reassortment Vaccines

5 rotavirus strains re-assorted to express multiple serotypes

  • live virus
  • given orally

10

Immunologic Bacterial Components

parts of baceria given to prevent reaction

  • pertussis
  • H. influenza B
  • Strep pneumonia
  • meningococcal

11

Toxoids

create immunity to toxin produced, not the germ

  • diptheria
  • tetanus

12

Vaccines not common in U.S.

  • cholera
  • smallpox
  • BCG (for TB)
  • typhoid fever
  • yellow fever

13

Dz, S/s, Complications, Dx, Tx

Measles (RNA virus)

  • S/s: Koplik spots, rash, fever, cough, coryza (inflammation w/ mucous in nasal mucosa), conjuntivitis
  • Comp:
    • otitis media, pneumonia, croup (steeple sign), diarrhea
    • acute encephalitis
    • fatality
    • subactue sclerosing panencepalitis (SSPE)
      • behavioral and intellectual decline, no tx
  • Dx: clinical, IgM/IgG serology
  • Tx: supportive care

14

Dz, S/s, Complications, Dx, Tx

Mumps (RNA virus)

  • S/s:
    • parotitis (swelling of parotid, sometimes other salivary)
    • painful w/ ingestion of sour substance
  • Complications:
    • orchitis if after puberty
    • arthritis, thyroiditis, mastitis, cerebellar ataxia, encephalitis, hearing loss
  • Dx: clinical, lgM/IgG serology
    • DDx: parotitis other causes
      •  Influenza A, EBV, parainfluenza, bactria
  • Tx: supportive

15

Dz, S/s, Complications, Dx, Tx

Rubella (RNA virus)

  • S/s:
    • generalized maculopapular rash
    • postauricular and occipital lymphadenopathy
    • polyarthralgia/arthiritis in teens and adults
  • Complications:
    • congenital most serious- first trimester
      • microcephaly, deafness, congenital heart dz, cataracts
      • lifelong sequelae requiring tx
  • Dx: serology IgM/IgG
  • Tx: supportive (this is a mild illness)

16

Dz, S/s, Complications, Dx, Tx

Varicella (Herpes virus)

  • S/s: pruritic vesicular rash, fever, gen. systemic illness
  • Complications:
    • bacterial infection in lesions, pneumonia, cerebellar ataxia, encephalitis, thrombocytopenia
    • severe if immunocompromised
    • milder after vaccination
  • Dx: clinical, polymerase chain reaction (PCR) test of vesicle fluid, IgM/IgG serology
  • Tx: supportive, VZIG (neonate, immuno.), Acyclovir interrupts viral replication

17

Dz, S/s, Complications, Dx, Tx

Shingles (Varicella zoster)

18

Dz, S/s, Complications, Dx, Tx

Diphtheria (Corynebacterium diphtheria)

  • S/s:
    • membranous pharyngitis, cervical adenpathy, low fever
  • Complications:
    • life-threatening respiratory obstruction
  • Dx:
    • culture on special agar medium sent to CDC
  • Tx
    • Equine antitoxin (must test for horse serum sensitivity)
    • Erythromycin or PCN alternatively

19

Dz, S/s, Complications, Dx, Tx

Tetanus (Clostridium tetani)

toxin of soil/intestinal bacteria or passed from mom causes illness

  • S/s: trismus, severe generalized muscle spasms
  • Complications
  • DDx:
    • must exclude strychnine, hypocalcemia, conversion disorder
  • Tx:
    • human tetanus immunoglobulin
    • metronidazole and PCN also given

20

Dz, S/s, Complications, Dx, Tx

Pertussis (Bordatella pertussis)

  • S/s: URI prodrome progressing to spasmotic coughing
  • Complications:
    • pneumonia, apnea, subdural/subconjunctival bleeding, death
  • Dx: PCR nasal/posterior pharynx swab
  • Tx:
    • Oral Azithromycin (reduces sx only in catarrhal stage)
    • convalescent stage can be weeks to months
    • vaccine only effective 3-5 years

21

Dz, S/s, Complications, Dx, Tx

Hemophilus influenza Type B (Hib bacteria)

(untypable not covered by immunization - less severe)

  • S/s:
    • site dependent: epiglottitis, meningitis (MCC age < 3), conjunctivitis, otitis media
  • Dx: culture from infected body fluid
  • Tx:
    • 2nd/3rd gen Cephalosporin
    • presumtive tx is multiple abx pending cultures
    • epiglotitis requires emergent airway procedure

22

Dz, S/s, Complications, Dx, Tx

Streptococcal pneumonia (S. pneumo, Staph pneumo)

Prevnar vaccine covers 23 strains fo S. pneumo

  • S/s: common cause of pneumonia, otitis media, sinusitis, conjunctivitis
  • Complications:
    • septicemia, meningitis (esp. very young/old)
  • Dx: culture of infected site (blood or CSF)
  • Tx:
    • usually presumptive - multiple abx

23

Dz, S/s, Complications, Dx, Tx

Neisseria meiningitidis

  • S/s: abrupt onset of fever, myalgias, malaise, variable rash
  • Complications:
    • meningococcemia and meningitis (MCC in children)
    • fulminant dz - limb ischemia, coagulopathy, shock, coma
  • Dx: bacterial culture of blood/CSF
  • Tx (meningococcal dz):
    • tx symptoms of shock / stay ahead of coagulopathy
    • broad spectrum abx pending culture
    • PCN G 300,000 U/kg daily
    • Rifampin, Ceftriaxone for prophylaxis of exposed

24

Dz, S/s, Complications, Dx, Tx

 

destruction of nerve cells in spinal cord

Polio virus

last US case 1979; still in Nigeria, Afghanistan, Pakistan

  • S/s:
    • muscle wasting- flaccid paralysis w/ loss of reflexes in affected limb
    • bulbar dz may lead to respiratory paralysis
    • sore throat, malaise, fever, HA
  • Tx: supportive

25

Dz, S/s, Complications, Dx, Tx

Hepatitis A (fecal-oral RNA virus)

  • S/s:
    • fever, malaise, abdominal pain, nausea, jaundice, itch
    • <6 asymptomatic, illness in older children/adults
  • Dx: viral titers
    • IgM shortly after infection (~2 wks)
    • IgG shortly after IgM and for life
  • Tx: supportive

26

HBV S/s, Complications, Dx, Tx

Hepatitis B (blood/body fluid DNA virus)

  • S/s:
    • chronic more likely in very young/old, immuno.
    • asymptomatic to fulminant
  • Dx:
    • Acute- HBsAg (surfact antigen) and HBeAg (envelope)
    • Chronic- IgM antibodies to core and envelope antigens (anti-HBc and anti-HBe)
    • Previous- IgG antibodies to surface and core antigens (anti-HBs and anti-HBC)
    • PCR test also available for HBV
  • ​Tx:
    • acute- none
    • chronic- antivirals

27

Rotavirus S/s, Complications, Dx, Tx

Rotavirus (RNA virus)

  • S/s: fever, vomiting, diarrhea typically after flu season
  • Complications: pt. contageous days before symptoms appear
  • Tx: supportive

28

Influenza S/s, Complications, Dx, Tx

3 viral types: A, B, C subclassified by

hemagglutinin and neuraminidase surface antigens

  • S/s: acute onset fever, malaise, myalgias, nasal congestion, cough
  • Complications: pneumococcal and staphylococcal pneumonia
  • Dx: test early or not at all
    • rapid influenza A and B test
    • serology better for follow-up
  • Tx: Antivirals only effective in first 24-48 hrs
    • recommended in kids w/ underlying illness
    • Oseltamivir (Tamiflu)
    • Zanamivir (Relenza)
    • Amantadine (Symmetrel)
    • Rimantadine (Flumadine)

29

HPV Types, S/s, Complications, Dx, Tx

14 types high risk genital CA (11, 16, 18 highest);

Type 6, 11 condyloma accuminata and respiratory papillomatosis

  • S/s:
    • common skin warts
    • condyloma accuminata - genital warts
    • persistent anogenital HPV infection
    • juvenile respiratory papillomatosis
  • Complications:
    • vulvar, vaginal, cervical, penile, anal CA
    • airway obstruction
  • Dx: visual inspection, PAP smear, molecular testing
  • Tx: elimination of lesions