Vaccine Preventable Diseases Part II

Question 1

What are the vacciens covered in Part II?

Answer 1

• Diphtheria, pertussis, tetanus
• Polio
• Hib
• Meningococcal
• Rotavirus
• MMR

Hiba the POLE dancer ROTATes and MEN go , I’d TAP that MMR.

Question 2

How is Diptheria transmitted?

• does natural immunity confer immunity?

Answer 2

direct contact with droplets from a cough or sneeze. resp diptheria affects mucous membranes of UPPER RESPIRATORY TRAC TONLY.

• no!

Question 3

How Tetanus transmitted?

• does natural immunity confer immunity?
• fatality rate w/o trx?

Answer 3

spread through spores that get into a wound.

* Infection does NOT CONFER IMMUNITY. Only means of protection is immunization. 

80% fatality without treatment. Have to be intubated otherwise stop breathing.

Question 4

What does Bordetella Pertussis cause?

• classic sx of whooping cough?
• how transmitted?
• is immunity following infeciton life long?

Answer 4

WHOOPING COUGH. –> VVERY SERIOUS IN YOUNG INFANTS CUZ LACK LUNG CAPACITY TO DEAL WITH IT.

• SX: paroxysmal cough - can’t breathe cuz coughing so hard, hence whooping cough cuz tryign to breathe against closed throat, can suffocate.
  Immunity NOT LIFELONG !!
• transmitted through direct contact with DROPLETS from a cough or sneeze (veryyy CONTAGIOUS).
• no! wanes after 4-20 yrs!!

Question 5

For any of the infections in dtap, does natural infection confer lifelong immunity?

Answer 5

no!

Question 6

Why did they switch from whole cell to acellular vaccine (DTaP)?.

Answer 6

Why did they switch from whole cell to acellular vaccine (DTaP)? Acellular is more specific and therefore less AE.

Question 7

Which 2 letter in Tdap changes depenidng on quanittiy?

Answer 7

the D and p. aP vs ap

D larger dose is for kids
d is for adutls.

Question 8

what are the 2 toxoid vaccines?

Answer 8

Diptheria and Tetanus

Question 9

diptheria toxoid vaccien protects against _______ effects of toxin only, and _______ can still occur.

Answer 9

diptheria toxoid vaccien protects against systemic effects of toxin only, and carriage can still occur.

Question 10

How many dose series is the:
- diptheria toxoid vaccien?
- tetatnus toxoid vaccieNe?
-pertussis vaccine?

Answer 10

3,3,2

Question 11

Tetatnus vaccine provides protection for at least how many years?

Answer 11

10

Question 12

What is the immunization schedule for Tdap?

Answer 12

Dtap as an infant, then (children over 7 shoudl get adult Tdap) Tdap in gr. 9 then every 10 years as an adult.

**All adults should receive one dose of Tdap vaccine if they have not previously received pertussis-containing vaccines in adulthood

Question 13

Why is Tdap recommended in pregnancy?

• Severe disease most in infants <__ mos. .
• Rising ________of pertusssis in US, canada uk.
• __________ activel transfereed through palcenta provide passive protection in first few months.
• universal vaccination programs in pregnancy are ___% effective at preventin whooping
  cough in infant s <8 wks .
• it’s _______ by NACI and SOGC.

Pub funded and Available through pharmacies?

Answer 13

• Severe disease most in infants <2 mos. .
• Rising incidence of pertusssis in US, canada uk.
• Maternal abys activel transfereed through palcenta provide passive protection in first few months.
• universal vaccination programs in pregnancy are 85% effective at preventin whooping
  cough in infant s <8 wks .
• it’s recommended by NACI and SOGC.

Pub funded and Available through pharmacies.

Question 14

Waht can multiple tetatnus shots cause? tetatnus shots shouldnt be given closer than how many years apart?

Answer 14

One situation we’re cautious with this vaccine:
If they’ve had arthrus rxn –> if you’ve had a ton of tetanus shots –> get hypersensitivity rxn in that area and get black ulcer leading to scar. Tetanus shots shouldn’t be given closer than ten years apart in these type pops.

Question 15

polio transmissioN/

Answer 15

fecal oral –> think: SHIThole countries as trump would say –> Afghan and Pakistan

Question 16

Does natural POLIO infection confer lifelong imunity?

Answer 16

Does natural POLIO infection confer lifelong imunity? Yes!

Question 17

when was the LAST CASE OF PARALYTIC POLIO IN CANDA?

Answer 17

1989

Question 18

POLIO REMAINS endemic in waht 2 countries?

Answer 18

afghanistan and pakistan –> think the brown countries roast their meat on a POLE (Gyros).

Question 19

what is the gold standard for indnicating polio in the community?

Answer 19

what is the gold standard for indnicating polio in the community? wastewater monitoring

Question 20

Waht kind of adults shoudl get the polio vaccine as an adult? (2)

Answer 20

Adults:
* Prev unimmunized should get full series
- If travellign to afg or pakistan should get booster dose.

Question 21

Why is the H.infl type B vaccine important ?

Answer 21

Why is the H.infl type B vaccine important ? Cuz Hib common cause of bacterial meningitis.

Question 22

how Hinfl type B (Hib) transmitted?

Natural immunity ____ confer imunity but no guarantee.

• is Hib vax indicated fro adults?

Answer 22

resp droplets or nasal or throat discharge . like coughing

Natural immunity May confer imunity but no guarantee.

Indciation:
- routine childhood vaccination. NO not indicated for adults

Question 23

How is Neisseria meningitidis transmitted?

Answer 23

resp droplets, close direct contact wiht mouth secretions.

Question 24

Meningitis Overall mortality: ___% (long-term sequelae include hearing loss, limb amputations, etc)

Answer 24

Overall mortality 10% (long-term sequelae include hearing loss, limb amputations, etc)

Question 25

5 serogroups (___?) cause nearly all invasive meningococcal diseases in Canada

Answer 25

5 serogroups (A, B, C, Y, and W135) cause nearly all invasive meningococcal diseases in Canada

Question 26

What are the 2 preps of the Meningococcal vaccine available?

Answer 26

there are only vaccines for serogroup B and C. - * Monovalent conjugate vaccines (Men-C-C): MENJUGATE®, NeisVac-C® - Serogroup B meningococcal vaccines: BEXSERO®, Trumenba®

Question 27

* either Men-C-C or Men-C-ACYW depending on local epidemiology, recommended routinely at ___ years of age and young adults, even if previously vaccinated as an infant

Answer 27

* either Men-C-C or Men-C-ACYW depending on local epidemiology, recommended routinely at 12 years of age and young adults, even if previously vaccinated as an infant

Question 28

When would adults need the meningococcal vaccine? * Individuals at high risk – re-vaccinate with Men-C-ACYW every 3 to 5 years ( (military personal, outbreak (lister), travel to certain areas) * ________ to areas where meningococcal vaccine recommended or required *____________ personnel who remain at risk every 5 years * Community ______

Answer 28

* Individuals at high risk – re-vaccinate with Men-C-ACYW every 3 to 5 years ( (military personal, outbreak (lister), travel to certain areas) * Travel to areas where meningococcal vaccine recommended or required * Military personnel who remain at risk every 5 years * Community outbreak

Question 29

Are there any NACI recommendations regarding men B vaccine?

Answer 29

nope!

Question 30

Waht kind of virus is ROTAVIRUS? - waht does it cause? - tranmsisison? - how contagious? - Most severe in what age group?

Answer 30

Non-enveloped virus (Reoviridae family) - Rotavirus is a contagious virus that can cause gastroenteritis (inflammation of the stomach and intestines) - fecal oral and fomites (ie/ not flushing toilet and toothbrush) --> Only takes small amount of virus, and highly infectious. Can have prolonged sheddding, even if they're bettter, condtinue to shed in stool for long time. Think: R for high R0 --> highly iNFECTIOUS/CONTAGIOUS!! - Think: ROTIs from indiia give you BAAD food poisoning and diarrhea (fecal oral). - Most severe in what age group? Kids < 5. after 5, most children have gotten rotavirus. This is a disease of kids <5 . Most severe in <2. by 3-5 yrs, most hcildren have gotten rotavirus.

Question 31

is rotavirus vax given to adutls? - waht si the roa of rotavirus vax? Indicaitons: - Start immunization at ____wks. Do NOT start after ____ wks. Cuz want series to be completed by __ months. Preterm: * Always go by _______ age . - how safe is this vax? - what is the one concerning AE, but that is very RARE? Describe. - getting vaccinated at an _____ incr risk of intussusception hugely.

Answer 31

no! it's a childhood only vax. - PO! {think: fecal--> OraL to remember mouth} Indicaitons: - Start immunization at 6 wks. Do NOT start after 15 wks. Cuz want series to be completed by 8 months. Preterm: * Always go by chronological age . - how safe is this vax? Very safe!!!! - what is the one concerning AE, but that is very RARE? Describe. --> INTUSSUSCEPTION: when intestine folds back in on itself --> very rare!!!! - Older age incr risk of intussusception hugely. That's why we don’t let ppl start it later.

Question 32

Deos natural measles infection confer lifelong immunity?

Answer 32

yes!

Question 33

Deos natural MUMPS infection confer lifelong immunity?

Answer 33

yes! - One dose is highly effective (100% with one dose) - only get two cuz it's a combo.

Question 34

rubella aka ______

Answer 34

german measles

Question 35

In waht population are we most concerned about RUBELLA? - what syndorme can rubella cause in pregnacy?

Answer 35

* TEEN AND ADULT, esp FEMALES: --> causes much ARTHRALGIAS AND ARTHRITIS. {think: RUBELLA --> rubber --> associated with teens!!!} - CONGENITAL RUBELLA SYNDROME (severe: causes hd, deafness, mental retardation etc). think": if you dont wear a rubber, you'll become a teen pregnancy.

Question 36

Measels Vaccine Indication: 1) If born before 19___, presumed exposed to measles. 2) If after 1970, and havent had lab confirmed case or 2 doses MMR, waht do you do?.

Answer 36

Measels Vaccine Indication: 1) If born before 1970, presumed exposed to measles. 2) If after 1970, and havent had lab confirmed case or 2 doses MMR, give a dose!!! (imp for healthcare workers).

Question 37

wahta re the only 2 contraindiciatiosn to LIVE vaccines?

Answer 37

significanylu immunocompromised and pregnancy

Question 38

what isthe only contraindicaiton to any vaccien (live or other)?

Answer 38

known anaphylaxis.

Question 39

live vaccines cannot be given under what age?

Answer 39

under 12 mos.

Question 40

- By grade 6, wanna make sure they have what 2 vacciens? Grade 9: - Wanna get final dose of ______ (final adult dose of 3) before regular 10 yr schedule. Before uni, get __________ series completed.

Answer 40

- By grade 6, wanna make sure they have what 2 vacciens? HepB** and HPV. Grade 9: - Wanna get final dose of dTAP (final adult dose of 3) before regular 10 yr schedule. Before uni, get Meningococcal series completed.

Question 41

T or F: Most live-attenuated and inactivated vaccines are safe in breastfeeding (except yellow fever)

Answer 41

true. Most live-attenuated and inactivated vaccines are safe in breastfeeding (except yellow fever)

Question 42

* All women screened prenatally for protection against waht 3 ifnections?

Answer 42

* All women screened prenatally for protection against * Rubella --> rubella syndrom ein baby. * Varicella (history confirmed or test for IgG antibodies) * Hepatitis B (carrier status) since 1985 --> high risk in infants .