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Respiratory Infections
Chickenpox
Agent Human Herpes Virus 3 or Varicella Zoster virus
Primary infection produces Chickenpox.
Reactivation- herpes zoster (shingles)
Source of infection Case of chickenpox
Communicable
period
2 days before rash to 5 days after
Secondary attack
rate
90%
Host Maximum- in children 4-10 years old.
Immunity One attack usually gives Life-long immunity
Mode of
transmission
Droplet infection, droplet nuclei
Contact- lesions of skin and mucosa
Congenital transmission
Incubation period 14-16 days (up to 3 weeks)
Case fatality Mortality in adults is 15 times higher as
compared to children
Pregnant women and immunosuppressed
Asymptomatic
infection
<5%
Rash Pleomorphism
Reservoir Human case; no animal reservoir
Maternal
Varicella
Infection during the first 28 weeks of gestation-
Congenital Varicella syndrome (CVS)
Infection late in gestation or immediately
following birth is referred to as 'neonatal
varicella'
Isolation Till scabbing or 6 days after rash
Immunization Varicella virus vaccine-
1-12 years – single dose
>12 years – 2 doses, atleast 4 weeks apart
Diagnosis IgM antibody
Treatment Acyclovir may be used in persons with
immunodeficiency, especially adults
Measles Agent Measles virus
Source of infection Case of measles (sub clinical- very rare)
No carriers
Mode of
transmission
Droplet infection and direct contact
Incubation period 8-15 days
Communicable
period
4 days before to 4 days after rash
Age 6 months 3 years
Clinical features Prodromal symptoms
Rash- maculo-papular
Koplik’s spots Bluish-white spots, on the buccal
mucosa opposite the first and second
lower molars
Complications Complications occur in 30% of cases
Most common complication- Otitis media
(10-15%)
Most serious complications - blindness,
encephalitis, severe diarrhea or severe
respiratory infections
Diagnosis anti-measles virus IgM antibodies
Treatment no specific treatment for measles.
Supportive care should be provided
Immunity Lifelong immunity
Control When measles incidence is less than 1
per 1 million.
Elimination Defined as absence of endemic measles
for a period of 12 or more months in the
presence of adequate surveillance
Measles Rubella campaign
Catch-up:
All the children between 9 months to 10 years will receive a supplementary dose of Measles-Rubella regardless of previous Measles vaccination or Measles illness
Keep-up:
To increase Measles-Rubella vaccination in routine immunization to more than 90% of successive birth cohorts
Follow-up:
every 3-5 years after catch-up phase, wherein all the children born after catch up phase and more than 9 months of age will be given an additional dose of Measles-Rubella vaccine regardless of previous Measles vaccination or Measles illness
Rubella Agent RNA Toga virus
Source of infection Mostly subclinical cases
Communicable
period
1 week before to 1 week after rash
Mode of
transmission
Droplet infection, droplet nuclei,
congenital transmission
Age 3-10 years
Immunity life-long immunity
Incubation period 18 days
Congenital rubella
syndrome
cataracts, sensorineural deafness);
cardiac and craniofacial anomalies
infection 4 weeks before conception to
20 weeks later
Diagnosis rubella IgM
Immunization Rubella containing vaccines
Priority
Women in reproductive ages –
Adolescent girls – School going girls -
infants
Mumps Agent Myxovirus parotiditis
Source of infection Clinical and subclinical cases (1/3rd)
Communicable
period
5 days before to 1 week after symptoms
onset
Secondary attack
rate
86%
Isolation Till swelling of parotids present
Age 5-9 years
Mode Droplet infection, direct contact
Incubation 18 days (up to 3 weeks)
Clinical features swelling of Parotids, Sublingual and
Submandibular gland
Complications Aseptic meningitis (50%)
Orchitis (50% post-pubertal males)
Oophoritis (5% of post-pubertal
females)
Diagnosis IgM antibodies
Reservoir Human cases, No carriers
Diphtheria
Agent Corynebacterium diphtheriae
Source of infection Carriers (95%) Cases (5%)
Communicable
period
Up to 4 weeks after disease onset
Modes of
transmission
Person to person through respiratory
droplet infection.
Age 1-5 years
Reservoir Human carriers and cases, no animal
reservoir
Incubation period 2-6 days
Clinical features Sore throat, cough, dysphonia or dysphagia
Characteristic membrane in the throat.
Diagnosis
Growth on Loeffler’s/Tellurite media
PCR test
Isolation
Till atleast 2 consecutive nose and throat
swabs, atleast 24 hours apart are negative.
Treatment Diphtheria antitoxin, 20,000-1 lac IU
Penicillin/ Erythromycin
Carriers management 10 days Erythromycin
Complications Systemic-
Diphtheric carditis, Diphtheric neuritis
Meningococcal Meningitis Agent Neisseria meningitidis
Source of
infection
Carriers (majority), Cases (minority)
Communicable
period
Till meningococci are absent from nasal/throat
swabs
Incubation
period
4 days (2-10 days)
Reservoir Human carriers. No Animal reservoir
Mode of
transmission
Droplet infection, close contact
Case fatality rate 9-12 %
Secondary attack
rate
2-3%
Temporal pattern late winter and early spring (dry season)
Age Children, mostly infants
Clinical
Presentation
stiff neck, high fever, sensitivity to light,
confusion, headaches and vomiting.
Management
Ceftriaxone is the drug of choice.
Carriers- Rifampicin
Pertussis Agent Bordetella pertussis, B. parapertussis
Source of infection Case- no subclinical case/ no carrier
Incubation period 7-10 days
Communicable
period
Up to 3 weeks
Age Infants and young children
Mode of transmission Droplet infection, direct contact
Incubation 1-2 weeks
Secondary attack
rate
90%
Reservoir Human cases
Clinical features Local disease
Catarrhal stage- 10 days
Paroxysmal stage – 2-4 weeks
Convalescent stage- 1-2 weeks
Complications Secondary bacterial pneumonia,
seizures, encephalopathy, otitis media,
anorexia and dehydration
Diagnosis Culture and PCR
Isolation 4 weeks
Management Cases- isolation
Cases- and contact- erythromycin – 10
days
All of the following statements are true about congenital rubella except- (AIPGME 2005, AIIMS 2011)
a)It is diagnosed when the infant has IgM antibodies at birth
b)It is diagnosed when IgG antibodies persist for more than 6 months
c)Most common congenital defects are deafness, cardiac malformations and cataract
d)Infection after 16 weeks of gestation results in major congenital defects
Recommended vaccination strategy for Rubella is to vaccinate first and foremost- (AIPGME 2007)
a)Women 15-49 years
b)Infants
c)Adolescent girls
d)Children 1-14 years
Which of the following is not true about measles? (AIPGME 2008)
a)High secondary attack rate
b)Only one strain causes infection
c)Not infectious in prodromal phase
d)Infection confers life-long immunity
Xavier and Yogender stay in the same hostel. Xavier develops infection with Group B meningococci. After a few days, Yogender develops infection due to Group C meningococci. All the following are true statements except- (AIPGME 2002)
a)Educate students about meningococcal transmission and take preventive measures
b)Chemoprophylaxis against both Group B and Group C
c)Vaccine prophylaxis of contact of Xavier
d)Vaccine prophylaxis of contact of Yogender
In Measles, when do the Koplik’s spots appear? (UPSC CMS 2011)
a)On the day that fever occurs
b)On the day that rashes appear
c)1-2 days before the rashes appear
d)1-2 days before the fever occurs
All of the following are true about varicella virus except (AIIMS 2010)
a)Prognosis is better when infection happens in early childhood
b)All stages of rash are seen at the same time
c)Secondary attack rate is 90%
d)Rash commonly seen in flexor area
Which of the following is least common complication of measles? (AIIMS 2007)
a)Diarrhea
b)Pneumonia
c)Otitis media
d)SSPE
True about Diphtheria are all except-
a)Carriers are more common sources of infection than cases
b)Incubation period is 2-6 days
c)Cows are the reservoir of infection
d)Diphtheria is an endemic disease in India
Recommended drug for chemoprophylaxis against H5N1 influenza is
a)Zanamivir
b)Oseltamivir
c)Amantadine
d)Rimantadine
All the following are complications of chickenpox, Except-
a)Varicella pneumonia in neonates
b)Cutaneous scars as birth defects
c)Reye’s syndrome
d)Macrocephaly in newborn following maternal varicella during pregnancy
MMR vaccine is recommended at the age of
a)9-12 months
b)16-24 months
c)2-3 years
d)10-19 years
Alimentary infections
Hepatitis A Causative agent Hepatitis A virus
Mode of
transmission
Feco-oral transmission
Commonest
Parenteral transmission
Sexual transmission amongst men
Incubation period 28 days
Reservoir of
infection
Cases of hepatitis A
Period of infectivity 1-2 weeks before onset to 3 weeks
after onset.
Clinical
features
Among children <6 years of age, most
(70%) infections are asymptomatic.
Among older children and adults,
infection is usually symptomatic with
jaundice occurring in >70% of patients.
Carrier No chronic or carrier state
Diagnosis anti-HAV IgM antibody
Vaccines Inactivated whole virus hepatitis A
vaccines
Combination vaccine with Hepatitis B is
also available.
Cholera
Agent Vibrio cholera O1, ElTor biotype, Ogawa
serotype; Vibrio parahemolyticus
Reservoir Human cases and carriers
Cases Most are mild and asymptomatic
Communicability 7 to 10 days
Host-age Highest incidence in children
Transmission Direct contact, through focally
contaminated water, food
Incubation period 1-2 days
Diagnosis Dark field microscopy or stool culture.
Treatment Oral rehydration solution / intravenous
fluids.
Adults – Doxycycline
Children- Cotrimoxazole
Pregnant- Furazolidone
Chemoprophylaxis- Tetracycline
Vaccines ShanChol, Dukoral
Oral, killed vaccine
Typhoid Agent Salmonella typhi, Salmonella paratyphi A&
B
Reservoir Man- cases and carriers
Carriers Incubatory carrier – 1 week
Convalescent carrier- 6-8 weeks
Chronic carriers- > 1 year
Infective material Urine and stool
Age 5-19 years, more in males
Incubation 10-14 days
Transmission Feco-oral, urine-oral
Diagnosis Blood culture, Widal
Treatment of
carriers
Ampicillin- 4-6 gm./day-6 weeks
Cholecystectomy
Treatment Cephalosporins – 3rd generation
Vaccine Vi polysaccharide vaccine- > 2 years,
single-dose, revaccination after 3
years, subcutaneously/IM
Regarding ETEC, true is (AIIMS 2010)
a)Invades sub-mucosa
b)Most common in children
c)Fomite borne
d)Not the most common cause of traveller's diarrhea
The false statement regarding oral cholera vaccine, Shanchol is-
a)It should not be used in infants
b)It needs to be administered in two doses 14 days apart
c)It is constitutionally same as mORCVAX vaccine
d)It provides some protection against ETEC infections.
Regarding Typhoid, the correct statement is-
a)Chronic carriers are those who excrete the bacilli for more than 6 months
b)Carrier rate is higher amongst males
c)Phage typing is epidemiologically useful in tracing the source of epidemic
d)Cell mediated immunity plays minimal role
Which one of the following gives strong evidence of typhoid fever carrier status?
a)Isolation of core antigen
b)Isolation of Vi antigen
c)Persistence of Vi antibodies
d)Demonstration of typhoid bacilli in stools
Cholecystectomy is done for the treatment of carriers in –
a)Amoebiasis
b)Cholera
c)Hepatitis B
d)Typhoid
A village affected with epidemic of cholera, what is the first step that should be taken to stop the epidemic?
a)Safe water supply and sanitation
b)Cholera vaccination to all individuals
c)Primary chemoprophylaxis
d)Treat everyone in the village with tetracycline
Vector-Borne Diseases
Dengue Agent Dengue viruses (DEN-1, DEN-2, DEN-3
and DEN-4)
Immunity Each serotype provides specific lifetime
immunity and short- term cross - immunity.
Vector Aedes aegypti
Mode of
transmission
Bite of infected female aedes mosquito
Reservoir Humans and monkeys
Incubation period 4-7 days
Clinical
presentation
The majority are asymptomatic.
The most common presentation is the
sudden onset of fever accompanied by
headache, retro-orbital pain, generalized
myalgia and arthralgia
Rash
Laboratory
presentation
Leukopenia and thrombocytopenia
Laboratory
confirmation
IgM –ELISA or RT-PCR
Dengue non-structural protein 1 (NS1)]
Dengue Hemorrhagic Fever Dengue with
Hemorrhagic tendencies
• Positive tourniquet test
• Petechiae, ecchymosis or purpura
• Bleeding from mucosa, gastrointestinal tract, injection sites or other sites
Plus
Thrombocytopenia (<100,000 cells per cu.mm.)
Plus
Evidence of plasma
• A rise in average hematocrit > 20%
• Signs of plasma leakage (pleural effusion, ascites, hypoproteinemia)
Dengue Shock Syndrome
All the criteria for DHF
Plus
Evidence of circulatory failure manifested by rapid and weak pulse and narrow pulse pressure (<20 mm Hg) or hypotension for age, cold and clammy skin and restlessness.
Japanese Encephalitis Agent Group B arbovirus
Vector C. tritaeniorhynchus, C. vishnui, C. gelidus
Host Pig- amplifier host
Man-accidental, dead end host
Iceberg
disease
For every 1 symptomatic patient, there will
be 300 to 1000 asymptomatic infected
persons.
Incubation
period
5 to 15 days
Mode of
transmission
Bite of female Culex mosquitoes
Reservoir of
infection
Birds (Herons and egrets), pigs
Symptoms Mild infections occur without apparent
symptoms
More severe infection is marked by
headache, high fever, neck stiffness,
stupor, disorientation, coma, and spastic
paralysis.
Kala Azar
Other names Visceral Leishmaniasis
Agent Leishmania donovani
Vector Sandfly (Phleboptomous argentipes)
Forms of
Leishmaniasis
Cutaneous, Mucocutaneous, Visceral
or Kala Azar
Reservoir Man
Asian VL has no animal reservoir
Age 5-9 years
Clinical features High fever, weight loss, enlarged liver
and spleen and anemia
Altitude Doesn’t occur beyond 2000 feet
Mode of
transmission
Bite of infected female sandflies
Blood transfusion, sharing needles and
syringes, organ donation
Diagnosis rK39 Rapid kit
Treatment Liposomal Amphotericin B
Lymphatic filariasis
Agent Wuchereria bancrofti
Mode of
transmission
Bite of female Culex mosquito
Vector Culex quinquifasciatus
Reservoir Humans are the only reservoir of
infection
Elimination /
Treatment
DEC
Chikungunya
Agent Chikungunya virus
Vector Aedes aegypti and Aedes albopictus
Reservoir Man
Mode of
transmission
Bite of mosquito, day time biting
Incubation period 4-8 days
Symptom Fever with Joint Pain
Diagnosis ELISA
Treatment There is no specific antiviral drug
treatment for chikungunya.
Symptomatic treatment
Yellow Fever
Agent Yellow fever virus (Flavivirus)
Geographical
location
15 N to 10 S
Vector Aedes aegypti (urban areas)
Aedes africanus and Aedes simpsoni
(Africa- Forest transmission)
Reservoir Sub-clinical human cases (urban)
Monkey (Rural and forest)
Mode of
transmission
Bite of female aedes mosquitoes
Incubation period 2-6 days
Period of
communicability
2 days after exposure to infection
till 3 days after onset of symptoms.
Clinical features Fever and Jaundice
Diagnosis PCR, IgM ELISA
Treatment Supportive care
Vaccination 17D strain
95% develop immune response in
2 weeks
0.5 ml SC
Yellow fever vaccination
• Travel to endemic countries
• The international Yellow fever vaccination certificate becomes valid 10 days after vaccination and remains valid lifelong
• Qurantine period- 6 days
Reservoir of Indian Kala Azar is- (AIIMS May 2003)
a) Man
b) Rodent
c) Canine
d) Equine
Which of these is not useful in the prevention of KFD? (AIIMS 2001)
a)Vaccination
b)Deforestation
c)Prevention of roaming cattle
d)Personal protection
Chikungunya is transmitted by (AIIMS 2010)
a)Aedes
b)Culex
c)Mansonoides
d)Anopheles
False about Japanese Encephalitis is- (AIIMS 2009)
a)Pigs are amplifier hosts
b)Water tanks serve as breeding sites
c)Transmitted by Culex mosquitoes
d)Two doses of vaccines are required
The incubation period of Yellow fever is (AIIMS 2004)
a)3-6 days
b)3-4 weeks
c)1-2 weeks
d)8-10 weeks
True statement regarding arbovirus-transmitted diseases is – (AIIMS 2010)
a)Yellow fever is endemic in India
b)Dengue has only one serotype
c)KFD was first identified in West Bengal
d)Chikungunya is transmitted by Aedes
In Japanese Encephalitis, which of the basic cycles of transmission mentioned below is not true? (UPSC CMS 2012)
a) Pig-Mosquito-pig
b) Cattle-mosquito-cattle
c) Man-mosquito-man
d) Bird-mosquito-bird
According to International health regulations, there is no risk of spread of Yellow fever, if the aedes aegypti index remains below (AIPGME 2004)
a) 1%
b) 5%
c) 8%
d) 10%
False about Leishmaniasis is- (AIPGME 2003)
a) Coinfection with AIDS is now emerging
b) Indian Leishmaniasis is a non-zoonotic infection with man as the sole reservoir
c) Aldehyde test of Napier is a good test for diagnosis
d) There are no drugs for personal prophylaxis
In Kyasanur Forest Disease, the amplifying host is
a) Pig
b) Monkey
c) Rat
d) Cattle
All of the following are true statements regarding filariasis except
a) Extrinsic incubation period is 10-14 days
b) No multiplication in the mosquito
c) Man is the intermediate host
d) Clinical incubation period is 8-16 months
Which of the following statements is false?
a) Lymphatic filariasis has been targeted for elimination
b) Strategy for elimination is by Annual Mass Drug Administration of DEC for 5 years or more
c) Children less than 2 years are not included in Annual Mass Drug Administration
d) DEC is safe in Pregnancy
Regarding Japanese Encephalitis the incorrect statement is-
a) Pigs are amplifier hosts
b) Culex vishnui is the vector
c) Man is the reservoir of infection
d) Vaccination of pigs is effective in controlling the disease transmission.
Zoonotic Diseases
Rabies
Agent Rabies Virus
Reservoir In developing countries- Dog
In developed countries- Fox, Racoon and
Coyote
Geographic
distribution
throughout the world, except in the
continents of Antarctica and Australia.
Around 50 countries are Rabies-free.
Animals
responsible for
transmission of
infection
Mainly dogs and cats
Modes of
transmission of
Rabies
- Bites from infected animals
- Licks on broken skin and mucous
membrane
- Scratches
Incubation period Average – 1-3 months
Ranges between 2 weeks to 6 years
Factors
influencing
incubation period
Site of bite, the amount of virus in saliva
of the biting animal, the virus strain, and
the age and immune status of the
victim.
Category Type of contact Recommended
treatment
I Licks on intact skin None
II Nibbling of uncovered skin
Minor scratches or abrasions
without bleeding.
Licks on broken skin
Vaccine
III Single or multiple
transdermal bites or
scratches. Contamination of
mucous membrane with
saliva
Administer rabies
Immunoglobulin
and vaccine
immediately
Passive immunization
• Passive immunization is carried out using either Equine Rabies Immunoglobulin (ERIG) or Human rabies Immunoglobulin (HRIG).
• Human Rabies Immunoglobulin (HRIG) - Dose: 20 IU per kg body weight (maximum 1500 IU).
• RIG should preferably be administered before administering the anti-rabies vaccination. It should, however, never be administered later than 7 days after start of vaccination
Vaccine schedules
Essen schedule:
• Five intramuscular injection administrations - on days 0, 3, 7, 14 and 28.
Zagreb Regimen:
• One dose of vaccine is administered intramuscularly into the left and one into the right upper arm (deltoid region) on day 0 followed by one dose into the upper arm (deltoid region) on days 7 and 21.
Updated Thai Red Cross Schedule
Regimen: 2-2-2-0-2 i.e. one dose of vaccine, in a volume of 0.1ml is given intradermally at two different lymphatic drainage sites, usually the left and right upper arm, on days 0,3,7 and 28.
Leptospirosis
Agent Leptospira interrogans (spirochete)
Geographic
distribution
tropical and subtropical areas with high
rainfall.
Source of
infection
Environment contaminated by urine of
infected animal
Reservoir of
infection
Rats and mice
Mode of
transmission
Direct - contact of exposed skin
(abrasions/cuts) or intact mucosa with
infected material (water contaminated
with urine of infected animal)
Incubation 10 days (4-20 days)
Symptoms Starts with a mild-flu-like illness.
Jaundice may be seen
Case Fatality
rate
5-30%
Occupation Agriculture, livestock farmers, sewer
workers, abattoir workers, meat and
animal handlers, veterinarians.
Chemoprophylaxis Doxycycline
Treatment Penicillin is the drug of choice.
Weil’s disease Fever, jaundice, renal failure,
haemorrhage, myocarditis with
arrhythmias, seen in less than 10%
cases
Plague
Agent Yersinia pestis
Source of
infection
Infected rodents, fleas, case of
pneumonic plague
Vector Rat flea (Xenopsylla cheopis), both
sexes bite and transmit
Reservoir Wild rodents
Incubation
period
Bubonic and septicemic plague- 2 to 7
days
Pneumonic plague- 1 to 3 days
Types Bubonic, Septicemic and Pneumonic
Diagnosis Laboratory- staining with Giemsa stain
to identify Y. pestis
Culture and serology
Management Isolation of all patients with
pneumonic plague
Streptomycin/Tetracycline
Control of fleas- DDT/BHC, Carbaryl,
Malathion dust up to 1 feet height
CFR 30-60%, if untreated
Chemoprophylaxis Tetracycline
For the treatment of a class III dog-bite, all of the following are correct, except- (AIPGME 2005)
a) Give immunoglobulins for passive immunity
b) Give ARV
c) Immediately stitch wound under antibiotic coverage
d) Immediately wash wounds with soap and water
Class II exposure in animal bites includes the following- (AIPGME 2003)
a) Licks on intact skin
b) Licks on a fresh wound
c) Scratch with oozing of blood on palm
d) Bites from wild animals
The most effective method to break transmission chain in plague is (AIIMS 2002)
a) Early detection and treatment
b) Control of fleas
c) Control of rodents
d) Vaccination
All of the following statements about plague are wrong, except- (AIIMS 2004)
a) Domestic rat is the main reservoir
b) Bubonic plague is the most common variety
c) The causative bacillus can survive up to 10 years in the soil of rodent burrows
d) The incubation period for pneumonic plague is one to two weeks
Most diagnostic of Rabies- (AIIMS 2010)
a) Negri bodies
b) Gaurneiri bodies
c) Cowdry A
d) Cowdry B
Pre-exposure prophylaxis for rabies is given on days-
a) 0,3,7,14,28,90
b) 0,3,7,28,90
c) 0,3
d) 0,7,28
Surface Infections
Tetanus
Agent Clostridium tetani- tetanospasmin
Reservoir Intestine of cattle
Source Soil and dust
Mode of
transmission
through contaminated wounds or tissue injuries Not transmitted from person to person.
Incubation period 7 days
CFR 40-80%
Age Neonates, 5 to 40 years
Occupation Agricultural workers
Immunity Maternal antibodies protect neonates.
There is no naturally-acquired immunity to
tetanus. Immunity to tetanus can be acquired
only by active or passive immunization.
No role of herd immunity
Treatment human tetanus immune globulin
Antibiotics - metronidazole or penicillin G.
Maternal and Neonatal Tetanus (MNT) Elimination Initiative
• To reduce MNT cases to such low levels that the disease is no longer a major public health problem
• Tetanus cannot be eradicated
• Neonatal tetanus elimination is defined as “less than one case of neonatal tetanus per 1000 live births in every district”
• Once NT elimination has been achieved, maternal tetanus is assumed to be eliminated.
• India achieved MNT elimination on May 15, 2015
Trachoma Agent Chlamydia trachomatis
Source of infection Ocular discharges of infected
persons, fomites
Reservoir of
infection
Children with active diseases
Age 2 to 5 years
Mode of
transmission
Direct contact with eye and nose
discharges
Contact with fomites
Flies (Musca sorbens)
Incubation 5 to 12 days
SAFE strategy Surgery for Trichiasis
Antibiotic treatment
Facial cleanliness
Environmental improvement,
improved access to water and
sanitation
If the baseline district prevalence of TF in 1–9-year-old
children is 10% or greater, antibiotic treatment of all
residents should be undertaken annually for 3 years.
Azithromycin (20 mg/kg) single dose is preferred
For the field diagnosis of trachoma, the WHO recommends that follicular and intense trachoma inflammation should be assessed in- (AIIMS May 2003)
a) Women aged 15-45 years
b) Population of 10-28 year range
c) Children aged 0-9 years
d) Population above 25 years of age irrespective of sex
All of the following are done to prevent tetanus neonatorum, except- (AIPGME 2007)
a) Two doses of TT to all pregnant women
b) TT to all females in reproductive age group
c) TT to all infants
d) Injection Penicillin to all newborns
SAFE strategy includes all of the following, except- (AIIMS 2006)
a) Screening
b) Antibiotics
c) Face washing
d) Environmental improvement
Regarding Clostridium tetani, all are true, except? (AIPGME 2011)
a) Spores are resistant to heat
b) 3 doses give immunity in primary immunization
c) Incubation period is 6-10 days
d) Person to person transmission occurs
All the following statements are true about Clostridium tetani infection, except- (AIIMS 2010)
a) Main reservoir is soil, animal and human intestine
b) Main mode of transmission is through trauma and contaminated wound
c) Herd immunity doesn’t have much value
d) Seen commonly in winter and dry climates
Neonatal tetanus is said to be eliminated when the rate is
a) >10 per 1000 live-births
b) >1 per 1000 live-births
c) <1per 1000 live-births
d) <0.1 per 1000 live-births
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