Infectious disease prevention (vaccines)

-assessment (monitor community health status)

-policy development

-implement programss

-provide community education

what are the main roles of the public health department?

Translate population-level data into individual patient care and vice versa.

what is the bride role of the family physician

expedited partner therapy

Providing prescriptions or medications to patients diagnosed with certain STIs (e.g., chlamydia, gonorrhea) for their sexual partners without prior medical evaluation of the partner.

Notifiable diseases (e.g., TB, measles, HIV, syphilis, hepatitis, COVID-19).

Outbreaks or clusters of unusual illness.

Bioterrorism-related events (e.g., anthrax).

main indications to report a pt illness

1. identify the case

2. collect required data: patient identifiers, dx and date of onset, lab results

3. report promptly to local or state health department (most within 24-72 hrs)

4. cooperate with public heallth officials

steps to reporting an infectiouss disease

For all unvaccinated HCP with risk of exposure to blood/body fluids.

is Hep B vax recommendedd for healthcare professionals

For microbiologists exposed to isolates.

for which heallthcare professionals is the mengicoccal vaccine recommended for?

3 samples for AFB smear + culture (gold standard), NAAT for rapid ID.

standard sputum studies for active TB

RIPE therapy: Rifampin, Isoniazid, Pyrazinamide, Ethambutol × 2 months → then INH + Rifampin × 4 months (total = 6 months).

Directly observed therapy (DOT) recommended.

treatment for active TB

INH daily × 9 months (preferred in pregnancy).

Rifampin daily × 4 months (alternative)

treatments for latent TB

Influenza viruses undergo antigenic drift (frequent small mutations in hemagglutinin/neuraminidase genes).

why are changes to the flu vaccine necessary every year?

antigenic shift

major change in influenza virus antigen due to gene reassortment

Azithromycin (preferred) or Amoxicillin (avoid doxycycline)

treatment for chh\lamydia in pregnan\ncy

Ceftriaxone (safe). Avoid fluoroquinolones.

tx for gonorrhea in pregnancy

Penicillin G benzathine (desensitize if allergic).

tx for syphilis in pregnancy

Metronidazole is safe (single dose or 7-day regimen).

tx for trichomonas in pregnancy

Acyclovir/Valacyclovir safe; suppressive therapy may be used near delivery.

tx for HSV dduring pregnancy

Same first-line treatments, but often require longer duration (e.g., syphilis therapy).

Drug-drug interactions with ART must be considered (e.g., rifampin and protease inhibitors).

principles of treatment for STIs in pts with HIV

INH daily × 9 month

treatment for latent TB in pregnancy

2-dose series: 12-15 months and 4-6 years

recommendedd varicella schedule in children

Adults without prior immunity: 2 doses, ≥4 weeks apart

recommended varicella scheduel in adults

Adults ≥65 years

Adults

recommendation for pneumococcal vaccine

2-dose series at ≥50 years, 2-6 months apart

Also for immunocompromised adults ≥19 years

recomenddations for the shingles vaaccine (Recombinant Zoster Vaccine, RZV / Shingrix):

MenACWY

meningitis vaccine type for 11-12 year olds, booster at 16

MenB

meningitis vaccine ffor 16-23 years (preferred 16-18, esp. for college/military)

live attenuated vaccines

Contain weakened but live organisms

produce strong, long-lasting immunity (often after 1-2 doses)

MMR, Varicella, Yellow fever, Intranasal influenza, Rotavirus

examples of live attenuated vaccines

inactivated vaccines

Contain killed organisms or parts (proteins, polysaccharides, mRNA)

Often require boosters to maintain immunity

Tdap, Hepatitis A & B, HPV, Influenza (IM), Pneumococcal, Meningococcal, COVID-19 vaccines

examplels of inactivated vaccines

Inactivated influenza (any trimester)

Tdap (between 27-36 weeks gestation) - provides passive immunity to newborn

recommended vaccines in pregnancy

between 27-36 weeks gestation

when should you ggive Tdap in pregnancy?

Varicella

MMR

Live attenuated influenza (nasal)

HPV (not recommended in pregnancy)

vaccines contraindicated in pregnancy