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29 Cards in this Set

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What are 4 contraindications to live vaccines?
1. pregnancy
2. allergies
3. immunosupression
4. HIV
What are 6 routine vaccinations for travel?
1. update poli, tetanus, diphtheria (if 10 years + since previous
2. influenza (elderly, at risk)
3. pneumococcal
4. meningococcal
5. MMR
6. BCG
Where have there been recent polio outbreaks?
Africa,Indonesia
What vaccines are needed for travel outside of N. Western Europe, N. America, Japan, Australia, New Zealand?
1. typhoid and Hep A
What are the 2 types of typhoid vaccine?
1. polysaccharide Vi (inactivated vagella), lasts 3 years
2. Oral typhoid vaccine (LIVE), lasts 1 year

*both have about 80% efficacy
What is the vaccine type for Cholera and the dose scedule?
killed (give 2 doses 1 week apart) and live attenuated oral vaccine (1 dose)
What is the Hepatitis A Vaccine?
inactivated vaccine (two doses, 6-12 months apart, covers 10 years)
What are 4 compulsory vaccinations for endemic area travel?
1. yellow fever (S. America, Africa)
2. meningococcal
3. cholera
4. smallpox
What is the yellow fever vaccine?
-contraindications:
live attenuated viral vaccine (takes 10 days to be effective after dose)

-c/i: egg or gelatine allergy
What are side effects to yellow fever vaccine
-s/e:
*1. headache, myalgia 2-5%, or *2. YEL-AND severe neurological effects (encephalitis, guillan barre, demyelination, 5% mortality rate)
*3. YEL-AVD: like wild type yellow fever, 50% mortality
For travel to where is the meningococcal meningitis vaccine -required?
-recommended?
-Haj, Saudi Arabia
-meningitis belt in africa
What are "special case" vaccines?
1. Hep B
2. Rabies
3. Japanese B encephalitis
4. Tick borne encephalitis
Who is Hep B recommended for?
1. all children, young adults and high risk behavior
2. long term travellers
3. occupation risk
4. frequent travellers
For where is Rabies vaccine recommended?
-central and tropical s. america
-indian
-far east
*invariably fatal disease
For whom is Japanese B encephalitis recommended?
-short term travellers to far east, India (rural disease)
-What is the source of Japanese B encephalitis vaccine?
-Side effects
-mouse brain
-anaphylaxis and encephalitis
-Where/when does ARBO dz, "Tick Borne Encephalitis" occur?
-Central and Northern Europe,
-USSR
-rural, forested area, from drinking goats milk
-occurs in spring, early summer
Revise some facts on Malaria's (give numbers infected etc.) impact on health worldwide:
1. 1.5-2.7 million killed/year, and 300-500 million new cases/year
2. 1/2 of world population is at risk
3. 10% of W. African children killed/year
4. occurs in 100 cases (with 125 million travels/year)
Where is malaria and resistant malaria most common:
1. sub-saharan africa
2. pockets in se asia (highly drug resistant)
3. India (lots of vivax)
4. South America: amazon (highly drug resistant)
Who is most at risk for contracting malaria?
1. tourists, VFR, ex-patriots
2. immigrants
3. airport
4. IVDU, transfusion
5. vertical transmission
What are Risk factors for malaria:
1. age (young)
2. history of exposure (lost immunity, burkitt's lymphoma, funny blood)
3. pregnancy
What are generalized symptoms of Falciparum Malaria?
1. fever/chills
2. dizzy
3. backache
4. myalgia
What are abdominal symptoms of Falciparum Malaria?
1. anorexia, nausea, vomitting
2. abdominal pain
3. diarrhea
What are respiratory symptoms of Falciparum Malaria?
1. dry cough
2. SOB
What are symptoms of Falciparum Malaria in children under 5?
1. drowsy
2. "off" feed
3. thirst
4. vomiting, diarrhoea
5. cyanosis
6. convulsions
What are symptoms of Falciparum Malaria in PREGNANCY?
1. relapses (due to immunosupression in pregnancy)
2. ARF
3. hypoglycaemia
4. cause of abortion, stillbirth and neonatal deaths
What are the risks of being bitten by a malaria carrying mosquito in:
West Africa
East Africa
India
Thailand
West Africa 1:1 day of travel
East Africa 1:10 days of travel
India 1: Month of travel
Thailand 1:10 months of travel
What drugs are for malaria prophylaxis?
1. Chloroquine and proguanil (reduced efficacy in Africa, not for other areas, for india or ex-pats)
2. Mefloquine-Lariam (>90% effective)
3. Doxycycline (>90% effective in Africa and Asia, C/I in children and pregnancy)
4. Atovaquone/proguanil – Malarone (98% effective in Africa)
Give the S/E for:
1. Chloroquine and proguanil
2. Mefloquine - Lariam
3. Doxycycline
4. Atovaquone/proguanil – Malarone
1. GIT, mouth ulcers, hair loss, itch
2. dizzy, nausea, vomiting, myalgia, athralgia, fatigue, psychoneurological
3. photosensitivity, superinfections, not for kids
4.GI, headache, cough