chapter 4 community

menyion 4 types of carriers and their definitions

mention importance of incubation period

1.preventive measures may be carried out during it to prevent occurence of disease or decrease severity

2. surveillance of contacts of a communicable disease

3. quarantine

4. tracing source of infection

5. estimating prognosis

explain epidemiology of measles

1. person: acquired in first 10 years of life, any social class may be affected

2. time distribution: seasonal flactuations more prevalent during spring and winter

3. place distribution: worldwide

measles MOT, reservoir and IP and POC

airborne or droplet

cases

IP:7-21 DAYS(commonly 10 and 14 till rash

POC:4 days before rash and 4 days after rash

general measures for preventing droppet infection

1. environmental sanitation

2. health education: hygeine, ventilation, avoid smoking and adequate nutrition

prevention of measles

1. general measures

2. specific measures: active immunization (live attenuated vaccine) 95% for 15 years

3. control:

1. verify diagnosis

2. notify local authorities

3. isolate at home for 4 days after rash

4. symptomatic treatment

5. identify susceptible and non-susceptible contacts

6. surveillance for 10 days of non susceptible group

7. separate susceptible group from cases and survey for 10 days

8. health education

measles vaccine CI

primary immune deficiency

severe acute illness

anaphylaxis

pregnant women

measles elimination plan

high immunization levels

strong surveillance

aggressive outbreak control

rubella epidemiology

person: anyone not immune

time: late winter and early spring

place: worldwide

mention reservoir, IP, MOT and POC of rubella

clinical or subclinical cases

2 to 3 weeks

person to person, vertical and contaminated objects

one week before rash and one week after

prevention and control of rubella

General measures,

specific measures:

active immunization: live attenuated vaccines last for 3-7 years

Mumps epidemiology

1. Person: young and middle aged adults after vaccine, before vaccine: children

2. time: spring and late autumn

3. place: worldwide throughout the year

mumps reservoir, MOT, IP and POC

clinical or subclinical

direct or contact

14-25

7 days before and 9 days after onset of parotitis

prevention and control of mumps

general measures

specific: vaccine life long

control: isolate for 9 days after onset

onlu immunize susceptible contacts

varicella(chicken pox) epidemiology

person: children especially under 10 and adults who didn't get chickenpox as kids and not vaccinated, Immunocompromised are at an increased rosk

place: worldwide

time: sporadic during winter and spring

chicken pox(varicella) reservoir, MOT, IP AND POC

human cases only

Direct droplet and indirect fomites

2-3 weeks

one or two days before appearance of rash and 6 days after until all lesions are crusted

prevention of chicken pox

general,

specific:

1. active immunization live attenuated, two doses, 0.5ml

2. schedule first at 12-15 months, second 3 months after or at 4-6 years

3. side effect of vaccine: transmission of virus

4. mild cases may occur among vaccinated

5. varicella vaccine for post exposure above 12 months

Passive immunization(VZIG): 72 HOURS for high risk, lasts at least 3 weeks

control of varicella(chickenpox)

isolate at home and prevent secondary infection

disinfect contaminated fomites

survey for 3 weeks

seroprophalyxis for high risk close contacts using VZIG

vaccinate people above 12 months who have no immunity to varicella EXCEPT: PREGNANT WOMEN AND IMMUNOCOMPROMISED

prevention of herpes zoster(shingles(

recombinant zoster(shingles) vaccine called shingrix

given in two dosees for

adults 50 years+ separated by 2-6 months

adults 19+ with weakened immune system 2 doses separated by 1-2 months

VZIG: 72-96 hrs after exposure