Both active and passive immunization is given in all, EXCEPT:
## **Core Concept**
The question tests the understanding of active and passive immunization strategies. Active immunization involves administering vaccines to stimulate the body's immune system to produce antibodies and immune cells that can recognize and attack specific pathogens. Passive immunization involves providing pre-formed antibodies to individuals to give them immediate protection against specific diseases.
## **Why the Correct Answer is Right**
Hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine are given together for post-exposure prophylaxis, especially in newborns of hepatitis B-positive mothers, combining passive (HBIG) and active (vaccine) immunization. Similarly, rabies immunoglobulin and the rabies vaccine are administered together for post-exposure prophylaxis. Tetanus immunoglobulin can be given along with tetanus toxoid vaccine in cases of tetanus-prone wounds in individuals who have not been adequately vaccinated. However, in the case of **D. Typhoid**, the typical approach is vaccination (active immunization) for travelers to endemic areas or for individuals at high risk. There is no standard recommendation for combining typhoid vaccine with typhoid immunoglobulin for routine immunization or prophylaxis.
## **Why Each Wrong Option is Incorrect**
- **Option A: Hepatitis B** - Both HBIG and hepatitis B vaccine are given for post-exposure prophylaxis, making it a scenario where both active and passive immunization are utilized.
- **Option B: Rabies** - Post-exposure prophylaxis includes both rabies vaccine and rabies immunoglobulin, combining active and passive immunity.
- **Option C: Tetanus** - In cases of wounds prone to tetanus in inadequately vaccinated individuals, tetanus toxoid (active) and tetanus immunoglobulin (passive) can be given together.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that for immediate protection against certain infections, especially post-exposure, combining active and passive immunization can be life-saving. However, not all vaccines or infections warrant this dual approach. Specifically, for **typhoid fever**, vaccination is the mainstay of prevention, and there's no commonly recommended scenario for using both active (vaccine) and passive (immunoglobulin) immunization together.
## **Correct Answer:** D. Typhoid.