(2) Paramyxoviruses and Rubella Virus Flashcards
Paramyxoviruses and Rubella Virus
All viruses initiate infection via the respiratory tract & limited to respiratory epithelia except
measles & mumps (dessiminated, viremia is present)
enumerate the structure of paramyxovirus
- Pleomorphic
- enveloped viral genome: linear, (-) ss non-segmented RNA
- RNP
- Matrix Protein
- Hemagglutinin-neuromanidase (HN) protein
- Fusion Protein
structure - TOF
HN protein may or may not have hemagglutinin or neurominadase activity
True
Structure: Fusion protein - TOF
Majority of the virus has hemolysin activity
T
Outstanding characteristics of paramyxovirus
- Antigenically stable
- Particles are labile yet highly Infectious
(4) CLASSIFICATION
Paramyxoviridae
4 classification?
- Respirovirus
- Rubulavirus
- Morbilivirus
- Henipavirus
CLASSIFICATION
Pneumoviridae
- Pneumovirus
- Metapneumovirus
if u see this card
study the table for characteristics
To remember:
Respirovirus
Parainfluenza 1,3
To remember:
Rubulavirus
Diseases it manifests
- Mumps
- Parainfluenza 2, 4a, 4b
To remember:
Morbillivirus
Diseases it manifests
Measles
To remember:
Henipavirus
Disease it manifests
- Hendra
- Nipah
Under Pneumoviridae: Only those that are medicallyimportant
Pneumovirus
Respiratory syncytial virus
Under Pneumoviridae: Only those that are medically important
Metapneumovirus
Human metapneumovirus
viruses that have hemeagglutinin
- Parainfluenza 1, 3, 2, 4a, and 4b
- Mumps
- Measles
Viruses that have the ability for hemeadsorption
- Parainfluenza 1, 3, 2, 4a, and 4b
- Mumps
- Measles
Parainfluenza Virus - Epidemiology
Major cause of Lower Respiratory Tract Infection In young child.
Parainfluenza Virus
Pediatric Respiratory Tract Pathogen
Respiratory Syncytial Virus
and Parainfluenza virus
Parainfluenza Virus - Epidemiology
most prevalent; endemic
Type 3
Parainfluenza Virus - Epidemiology
epidemic
Types 1 and 2
Parainfluenza Virus - Epidemiology
Mode of transmission
person to person or large droplet nuclei
Parainfluenza Virus - Epidemiology
incubation period
5-6days
Parainfluenza Virus - Epidemiology
Shedding
1 week (from the start of sign and symptoms)
Parainfluenza Virus - Infection
what is the syndrom called
common cold
Parainfluenza Virus - Infection
- non-specific flu like symptoms
- infection presentation
Common cold syndrome
Parainfluenza Virus - Infection
croup (laryngotracheobronchitis)
Type 1 & 2
Parainfluenza Virus - Infection
- Upper respiratory tract
- pediatric patients <2 (more common for them)
Type 1 & 2 : croup (laryngotracheobronchitis)
Parainfluenza Virus - Infection
Presentation of Type 1 & 2 : croup (laryngotracheobronchitis)
barking caugh and stridor (high pitch wheezing)
Parainfluenza Virus - Infection
pneumonia or bronchiolitis
What type of parainfluenza
Type 3
Parainfluenza Virus - Infection
- Virus can go down and infect low airways (lower tract of lungs)
- More susceptible to acquiring bacterial infection
Type 3: pneumonia or bronchiolitis
Parainfluenza Virus - Laboratory Diagnosis
enumerate the 4 lab diagnosis
- RT-PCR
- Ag Detection
- Serological Test
- Culture
Parainfluenza Virus - Laboratory Diagnosis
techniques under Ag detection
- direct immunofluorescence
- indirect immunofluorescence
Parainfluenza Virus - Laboratory Diagnosis
techniques under Serological test:
- Neutralization
- Hemagglutination Inhibition (HAI)
- Enzyme-linked immunosorbent assay (ELISA)
Parainfluenza Virus - Laboratory Diagnosis
techniques under culture
Continuous monkey kidney cell line
Parainfluenza Virus
Prevention and Treatment
- Ribavirin
- No vaccine
most imporant cause of lower respiratory tract illnes in infants and young children
Pediatric Respiratory Tract Pathogen
Respiratory Syncytial Virus
same as parainfluenza
Most common cause of bronchiolitis pneumonia in infants < 1yo
Peak incidence: <2 months
Respiratory Syncytial Virus
Most common viral pneumonia in <5yo
Respiratory Syncytial Virus
Respiratory Syncytial Virus - Infection
Incubation
3-5days
Respiratory Syncytial Virus - Infection
Shedding
1-3 wks in pediatrics
1-2 days in adults
Respiratory Syncytial Virus - Infection
enumerate the viral replication
viral replication in EC of Upper respiratory tract → Lower respiratory tract → bronchitis & pneumonia
Respiratory Syncytial Virus - Infection
Lower Respiratory tract infection
Bronchitis, bronchiolitis & interstitial pneumonia
Respiratory Syncytial Virus - Infection
TOF
Infection also of Otits media
F (otitis not otits)
Respiratory Syncytial Virus - Transmission
MOT
Large-particle droplets and contact with formites
Respiratory Syncytial Virus - Laboratory Diagnosis
enumerate the 5 lab diagnosis
- RT - PCR
- Culture
- Rapid antigen detection kits
- Shell vial culture
- Serological test
Respiratory Syncytial Virus - Laboratory Diagnosis
what are the medium for culture used
Hela & HEp2, Monkey Kidney & human diploid cell
Respiratory Syncytial Virus - Laboratory Diagnosis
culture for most sensitive for this particular virus
Hela & HEp2
Respiratory Syncytial Virus - Laboratory Diagnosis
TOF
Cultures shoud detect the CPE
Turth
Respiratory Syncytial Virus - Laboratory Diagnosis
CPE found
giant cells with syncitia
Respiratory Syncytial Virus - Laboratory Diagnosis
- for faster detection - 24 to 48 (use immunofluorescense)
- the sample can be used for RT-PCR
Shell vial culture
Respiratory Syncytial Virus - Laboratory Diagnosis
why HAI and hemeadsorption are not pwede for the testing
they do not hemeagglutinins
Respiratory Syncytial Virus
Prevention and Treatment
- Rivarbin
- No vaccine
- Supportive management <3 (symptoms lang pinapagaling_
- Endemically worldwide
- Primary an infection of children
Mumps
highest incidence 5-9yo
in <5yo → Upper respiratory tract infection
Mumps
Mumps - Infection
Mode of Transmission:
- direct contact
- airborne droplets
- formites
- contaminated saliva or urine
Mumps - Infection
ratio of asymptomatic
1/3 ; asymptomatic
Mumps - Infection
Primary replication
Epithelial cells of URT
Mumps - Infection
enumerate the route
Dessiminate in the blood (+) viremia → Salivary gland → other organs
possible infection for kidney
Mumps - Infection
Incubation
2-4 weeks (14-18 days)
Mumps - Infection
shedding
3 days before & 9 days after onset of salivary gland swelling (parotitis)
not an obligatory process in infection (parotitis)
Mumps - Clinical Presentation
Prodromal period of?
malaise & anorexia
non-specific symptoms
Mumps - Clinical Presentation
enlargement of?
parotid gland
Mumps - Clinical Presentation
CNS involvement around what percentage
`
10-20%
Mumps - Clinical Presentation
TOF
Testes and ovary may also be affected
True
Mumps - Clinical Presentation
if the mumps occurred during puberty what can happen
Testes and ovary may also be affected
Mumps - Clinical Presentation
what happen to male
20 to 50% develop orchitis (unilateral)
inflammation of one or both testicles
Mumps - Clinical Presentation
what happen to female
5% developing oophoritis (swelling of ovaries)
Mumps - Clinical Presentation
percentage of pancreattits occuring
4%
Mumps - Immunity
enumer8
- Lifelong immunity
- Passive immunity (from mother to baby)
Mumps - Laboratory Diagnosis
enumer7+1
- RT-PCR
- Culture: Monkey kidney cell
- Shell vial culture – Faster culture
- Rapid antigen detection kits
- Serological test
Mumps - Laboratory Diagnosis
specimen used
- Saliva
- CSF
- Urine
Mumps - Laboratory Diagnosisq
diagnosis are mainly based on?
mainly clinical symptoms (findings)
Mumps
Treatment:
- Supportive management
- Live attenuated mumps virus vaccine
- Highly infectious
- Single serotype (has vaccine)
- No animal reservoir
Measles (Rubeola)
- Endemic throughout the world
- Industrialize countries: 5-10 yo
- Developing countnes: <5 yo
Measles (Rubeola)
Measles (Rubeola) - Infection
Mode of Transmission:
respiratory inhalation
Measles (Rubeola) - Infection
enumerate the viral replication
Upper respiratory tract → Regional lymph node near RT → Primary viremia → Reticulo endothelial system (replication) → Secondary viremia → Epithelial surface of the body (skin, respiratory tract, Conjunctiva)
Measles (Rubeola) - Infection
ncubation period:
8-15 days - 3 weeks
Measles (Rubeola) - Infection
Shedding
prodromal phase (2-3 day) and First 2-4 days of rash
contagoius
Measles (Rubeola) - Infection
when will maculopapular rash appear
Macoules papulo rash (appear in 14th day, may circulation antibody na sa body)
Measles (Rubeola) - Clinical Manifestation
fever, sneezing coughing runny nose, redness of eye, Koplik spots, and lymphopenia
Prodromal phase
Measles (Rubeola) - Clinical Manifestation
what phase does koplik spot presents
prodormal phase
Measles (Rubeola) - Clinical Manifestation
- found in mouth or mucosa
- bucalmucosa opposite to molar
- looks like a salt
Koplik spots
Measles (Rubeola) - Clinical Manifestation
light pink maculopapular rash and coalesce to form blotches becoming brownish in 5-10 days
Rash
Measles (Rubeola) - Clinical Manifestation
rash will be resolved throu desquamation
branny desquamation
Measles (Rubeola) - Clinical Manifestation
COMPLICATIONS
- otitis media
- pneumonia
Measles (Rubeola) - Clinical Manifestation
enumerate the CNS complication
- Acute encephalitis
- Postinfectious encephalomyelitis (acute disseminated encephalomyelitis)
- Subacute Sclerosing Panencephalitis (SSPE)
Measles (Rubeola) - Clinical Manifestation
Long term Complication
SUBACUTE SCLORSING PANCEPHALITIS (SSPE)
Measles (Rubeola) - SUBACUTE SCLORSING PANCEPHALITIS (SSPE
Generally develops 7 to 10 years after a person has?
measles (even though the person seems to have fully recovered from the Illness.)
Measles (Rubeola) - Clinical Manifestation
A slow, but persistent. viral Infection caused by defective measles virus
SUBACUTE SCLEROSING PANENCEPHALITIS (SSPE)
Measles (Rubeola) - Clinical Manifestation
Risk of developing subacute Sclerosing Panencephalitis may be higher for a person who gets
measles before they are 2 years of age
Measles (Rubeola) - Clinical Manifestation
subacute Sclerosing Panencephalitis are characterized by
- progressive mental deterioration
- Involuntary movements
- muscle rigidity and
- possibly coma
Measles (Rubeola) - Laboratory diagnosis
enumerate
- RT-PCR
- Culture: MKC, HKC, Lumphoblastoid cell lines (B95-a)
- Shell vial culture
- Serological test
Measles (Rubeola) - Laboratory diagnosis
CPE
multinucleated giant cell containing both intranuclear and intracytoplasmin inclusion bodies
Measles (Rubeola)
Treatment and Prevention
- Vitamin A
- Ribarvin
- Live attenuated measles vaccine
Measles (Rubeola) - Treatment and Prevention
vaccine were available since
1963
Measles (Rubeola) - Treatment and Prevention
vaccine were derived from?
Edmonston strain of measles virus
Measles (Rubeola) - Treatment and Prevention
characteristic of edmosio strain
- Monovalent – alone, single
- Combined – with live attenuated rubella
Measles (Rubeola) - Treatment and Prevention
Edmosion strain of measles virus combined with Rubella =
Measles and Rubella (MR)
Measles (Rubeola) - Treatment and Prevention
Edmosion strain of measles virus combined with Rubella and mumps =
Rubella and Mumps (MMR)
Measles (Rubeola) - Treatment and Prevention
Edmosion strain of measles virus combined with Rubella and Varicella =
Varicella (MMRV)
Measles (Rubeola)
immunity
lifelon immunity
→ member of Togaviridae
→ sole member of Rubivirus
Rubella (German Measles or 3 day measles)
Rubella
Epidemiology
Worldwide distrubution
Rubella - Infection
TOF
Compared with measles, rubella is more contagious
F (not that contagious)
Rubella - Infection
Acute febrile illness characterized by
rash & lymphadenopathy
Rubella - Infection
Early stages of pregnancy (<20 weeks)
congenital rubella syndrome
(Teratogenic)
Rubella - Infection
incubatiobn period
12 days
Rubella - Infection
enumerate the viral replication
Replication in Upper Respiratory Tract → (inital dissemination – head and neck) Cervical lymphnode → Viremia → Antibody formation
Rubella - Infection
Rash will develop when antibody against the organism is available, what antibody
T-cell interaction = rash
Rubella - Clinical manifestation
enumerate
- Malaise, low grade fever
- Morbilliform rash
- Arthalgia and arthritis
Rubella - Clinical manifestation
Face then the rash will spread towards lower extremities
Morbilliform rash
Rubella - Clinical manifestation
what are the complication
- thrombocytopenic
- purpura
- encephalitis
Rubella
Immunity
Lifelong Immunity
Rubella
Enumerate the lab diagnosis
- RT-PCR
- Culture: Monkey Kidney Cell and Rabbit cell lines
- Shell vial culture
- Rapid antigen detection kits
- Serological test: Hemeagglutination inhibition and ELISA
Rubella
Treatment and Prevetion
- Supportive
- Live attenuated mumps virus vaccine
what is one clinical manifestation mentioned for rubella
CONGENITAL RUBELLA
Infection during the 1st trimester of pregnancy
CONGENITAL RUBELLA
Rubella
what are the 3 classic triad for congenital rubella
- Cataract
- Cardiac defects
- Deafness
Rubella
Most common developmental manifestation can be mental retardation for congenital rubella if?
if microcephaly is present
Rubella - CONGENITAL RUBELLA
Treatment
- No specific treatment – supportive
- Preventable with early vaccination Rubella