immunizations for travelers

sx hep a and b

Both types of hepatitis have a delay before symptoms are present. Symptoms can include fever, muscle aches, and jaundice. blood tests

hep a can be spread how

Can be spread from person to person or by eating contaminated foods (including fruits and shellfish) and water or ice.

typhoid fever tx

Cipro or Ceftriaxone; even after treatment, patients may still carry the bacteria and spread it; proper hand hygiene is very important; stool cultures will indicate when the bacteria has been eliminated

yellow fever contraindications

Contains egg, chicken proteins, gelatin and latex Women who are pregnant or breastfeeding should be evaluated prior to receiving the vaccine; pregnant women may have less immunity, and a booster may be required if antibody titers are low People with symptomatic HIV or CD4 counts <200/mm3 should not receive the vaccine; administer cautiously in patients with asymptomatic HIV with CD4 counts between 200 - 400/mm3 Avoid vaccinating those with thymus disorders, malignant tumors, or immunodeficiencies as well as in transplant patients or those on immunosuppressants.

japenese encephalitis vaccine name

JE-VC (Ixiatro)

serious s/e

Serious effects (most seen in people > 60 years) - nerve damage, Guillian-Barre and meningoencephalitis

typhoid fever is Spread between humans who are infected with or carry

Spread between humans who are infected with or carry

sx what re they and how long does it take to see them

Symptoms: temperatures as high as 102 degrees F - 104 degrees F, poor appetite and stomach pain Can take from 6-30 days after infection to see symptoms

After giving Mary Jo the vaccines she needs for travel, she experiences a reaction. Which of the following vaccine-related reactions must be reported to the VAERS? a. Only reactions that result in death. b. Only reactions that require the administration of epinephrine. c. Only reactions that show signs of respiratory distress. d. Any event listed in the package insert as a contraindication to additional doses.

d

What should you tell Mary Jo about the yellow fever vaccine? a. Adverse events usually aren't seen until about 10 days after vaccination. b. Serious adverse events are uncommon in people over 60 years old. c. She should wait at least 14 days before donating blood. d. Local pain at the injection site is usually felt within the first hour after vaccination.

d

Which of the following is a contraindication to the yellow fever vaccine? a. Patients on immunosuppressive therapy. b. Patients with symptomatic HIV or CD4 counts less than 200/mm3. c. Patients with malignant tumors. d. All of the above

d

typhoid fever is spread via

feces and is transmitted by improper handling of food or beverages by persons shedding the bacteria. -travelers most susceptible greatest risk- southern asia

yellow fever

live vaccine inactivated vaccines can be given at the same time or before or after yellow fever vaccine Vaccination must occur at least ten days prior to entering a country; if a booster is needed - should be given at ten year intervals.

yellow fever vaccine

mosquitoes South America (Brazil, Peru, etc) and sub-Saharan countries in Africa (Kenya, Nigeria) Highest risk - higher mosquito activity season (January - May, South American and August - October, Africa)

japanese encephalitis transmitted by

mosquitos -asia -Greatest risk - traveling outside of urban areas, staying for more than a month, or will be spending time outside in rural areas or national parks.

hep a vaccine

vaccine (Havrix, Vaqta) can be given at any time prior to departure for healthy people 40 years and under.

who's at highest risk for hep a

will be spending a lot of time in an undeveloped area, hiking into unpopulated areas, and eating in areas with poor sanitation

In which of the following travelers to Asia would it be most appropriate to give the Japanese encephalitis vaccine? a. A traveler doing volunteer work for eight weeks in a national park. b. A business traveler attending a one-week conference in an urban area during the rainy season. c. A 15 year-old foreign exchange student. d. A 60 year-old traveler on a cruise ship.

a

Which individuals are at highest risk of contracting hepatitis A? a. All travelers to international countries b. Only travelers over 60 years old c. Business travelers who will be at a hotel conference d. Aid workers who will be helping to rebuild after a natural disaster

a

Which of the following can help decrease Mary Jo's risk of contracting a vaccine-preventable illness? a. Spending most of her vacation working in a rural area. b. Traveling to an area during the rainy season. c. Beginning vaccinations early in the travel-planning process. d. Spending several months in an undeveloped are

c

Which travel-related disease can be treated with antibiotics? a. Yellow fever b. Japanese encephalitis c. Typhoid fever d. Hepatitis A

c

storage

refrigirator prior to use Any unused vaccine should be discarded within one hour of reconstitution

contraindications

- do not use in immunocompromised (including HIV) patients or those taking antibiotics at the time of or within 72 hours prior to vaccination. pregnant women fever gi upset rash

yellow fever vaccine recommendations

9 months or older traveling or moving to aforementioned areas should be vaccinated Central African Republic and Rwanda - require proof of vaccination prior to entry May be quarantined if received vaccine less than ten days prior to entry into the country Dose: 0.5 mL SC; observe patients for at least 15 minutes following vaccination

combinations hep b vaccine

A combination vaccine (Twinrix) containing both hepatitis A and B can be used on either a regular or shorter schedule. An accelerated schedule allows all three doses to be given over a 30-day period (days 0, 7, and 21-30) with a booster at twelve months

hep b vaccine

Engerix-B, Recombivax HB) - given as a three-part series at zero, one, and six months.

JE-VC (Ixiatro) age doses/days schedule requirements a/e- occur for how long storage

Only used for adults 17 years and older Requires two IM doses which given on days 0 and 28 Vaccination schedule must be completed at least one week prior to travel; a booster may be given if the original vaccination was given more than a year ago Adverse Events: mild (HA and flu-like illness) - may occur up to 7-10 days after vaccination; local pain and tenderness at the injection site Stored in the fridge; shake prior to administration

Which of the following is TRUE concerning documentation of the yellow fever vaccine? a. A copy of the vaccination record is sufficient for entering all countries that require the yellow fever vaccine. b. The International Certificate of Vaccination or Prophylaxis (ICVP) must be accurately completed. c. Documentation can only be given by centers designated by the Centers for Disease Control and Prevention (CDC) as a yellow fever vaccination center. d. The International Certificate of Vaccination or Prophylaxis (ICVP) is valid for ten years, beginning on the date of vaccination.

a

Which of the following is true when administering vaccines? a. Live vaccines can be given at the same time. b. Live vaccines should be separated by at least three months. c. Live vaccines can only be given prior to inactivated vaccines. d. Live vaccines can only be given after inactivated vaccines

a

hep b risks

aid workers health care workers travelers who participate in unprotected sex, tattoos, iv drug use

symptoms

occur within 5-15 days of exposure Headache, fever and vomiting; mental changes are seen a few days after this; Parkinson-like symptoms are common; seizures are seen more commonly in children

hep a contraindications

patients over 40, those with chronic liver disease, or those with CD4 counts less than 300/mm3 may have slightly less immunity. Patients with kidney or liver transplants may have their immunity decrease more quickly over time

symptoms of yellow fever

sudden fever and headache, nausea/vomiting, jaundice, bradycardia, etc)