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Microbiology Exam 3 > 41 - Viral Infections of the GI Tract II > Flashcards

41 - Viral Infections of the GI Tract II Flashcards

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1
Q

What virus family is the Poliovirus from?

A

Picornaviride family

RNA genome

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2
Q

How does the Poliovirus react to acidic pH?

A

It remains stable

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3
Q

There are three serotypes of the Poliovirus. What are they?

A

P1, P2, P3

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4
Q

How is the Poliovirus transmitted?

A

Fecal-oral route

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5
Q

What is the incubation period for the Poliovirus?

A

6-20 days

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6
Q

What percent of individuals infected with the Poliovirus are asymptomatic?

A

95%

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7
Q

What is problematic for the spread of the virus?

A

It can be shed in the stool for weeks following an infection

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8
Q

When did the Poliovirus peak in the US?

A

1952

We had 21,000 cases of paralysis from the Poliovirus

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9
Q

When was the last endemic case in the US?

A

1979

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10
Q

Is everywhere free of the Poliovirus?

A

No

Endemics are still active in

  • Afghanistan
  • Nigeria
  • Pakistan
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11
Q

When a patient is symptomatic, what are the three different types of clinical manifestations of the Poliovirus?

A
  • Abortive Poliomyelitis
  • Nonparalytic aseptic meningitis
  • Flaccid paralysis
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12
Q

What is abortive poliomyelitis?

A
  • Sore throat
  • Fever
  • Vomiting and abdominal pain
  • Constipation
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13
Q

What is nonparalytic aseptic meningitis?

A

Nonspecific prodromal symptoms

  • Stiffness in back, neck or legs
  • Lasts 2-10 days
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14
Q

How common is nonparalytic aseptic meningitis?

A

Only seen in 1-2% of cases

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15
Q

How common is flaccid paralysis from Poliovirus?

A

Seen in less than 1% of cases

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16
Q

How do you diagnose Poliovirus?

A
  • Isolate virus in the stool of patient

- Sequence isolate to determine if it originated from wild type or vaccine strain

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17
Q

What type of Poliovirus vaccine was used in the US from 1955 to 1963?

A

Inactivated polio vaccine

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18
Q

What type of Poliovirus vaccine was used in the US from 1963 to 2000?

A

Trivalent, live attenuated oral polio vaccine

Given on a sugar cube

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19
Q

How did the trivalent live attenuated oral polio vaccine function?

A
  • Replicates in GI tract
  • Shed in stool of vaccinated individual for up to 6 weeks
  • Very few cases of VAPP resulted

Vaccine Associated Paralytic Poliomyelitis

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20
Q

What changed in 2000?

A

Recommendation became to use ONLY the inactivated polio vaccine in the US

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21
Q

How do we create the inactivated polio vaccine?

A

Contains antigens to all 3 serotypes

  • Grown in tissue culture
  • Inactivated through formaldehyde
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22
Q

Is there any risk for VAPP in the inactivated form?

A

NO

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23
Q

What is viral gastroenteritis?

A

Inflammation of the stomach and intestines

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24
Q

What are the symptoms of gastroenteritis?

A
  • Nausea
  • Diarrhea
  • Vomiting
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25
Q

How is viral gastroenteritis transmitted?

A

Fecal-oral transmission

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26
Q

Are the viruses that cause viral gastroenteritis enveloped?

A

No, non-enveloped

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27
Q

What are the four viruses that cause viral gastroenteritis?

A

1 - Rotavirus
2 - Norovirus
3 - Adenovirus
4 - Astrovirus

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28
Q

What are the signs of severe dehydration?

A
  • Rapid, weak pulse
  • Sunken eyes
  • Absent tears
  • Skin tenting
  • Lack of urination
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29
Q

How do you treat mild dehydration?

A

Oral rehydration

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30
Q

How do you treat severe dehydration?

A

IV rehydration

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31
Q

How common is the rotavirus?

A
  • 95% of children are infected by 5 years of age

- 2.7 million cases per year in US

32
Q

When is rotavirus most severe?

A

3-24 months

33
Q

When is the highest incidence of rotavirus?

A

3 to 35 months of age

34
Q

What is the incubation period for the rotavirus?

A

1-3 days

35
Q

What symptoms do you see with rotavirus?

A
  • Vomiting and diarrhea for 4-7 days
  • Occasional cough and coryza
  • High fever
36
Q

Why is the rotavirus of concern?

A

There is a risk of complications from acute infections in very young or malnourished

37
Q

Is rotavirus a major opportunistic pathogen for HIV patients?

A

NO

38
Q

What do we see in cases of immunocompromised children?

A

Severe and prolonged disease in children

39
Q

Are there seasonal peaks of rotavirus?

A

Yes, depends on the region and season…

February/March is the peak in Iowa

40
Q

Do a lot of viral particles have to be ingested in order to cause an infection?

A

No - the infectious dose is less than 10 particles

41
Q

How many particles are found in a stool?

A

10 billion particles

42
Q

What type of diarrhea does the rotavirus cause?

A

MALABSORPTIVE diarrhea

43
Q

What other virulence factor does rotavirus have?

A

It produces a toxin (NSP4) that causes Ca++ release

44
Q

What else do we see with rotavirus pathology?

A

Villi blunting

Shortening and thickening instead of long narrow villi

45
Q

How do you diagnose the rotavirus?

A

EIA from stool sample

Less commonly EM, RT-PCR

46
Q

How do you treat rotavirus?

A
  • Oral rehydration therapy

- IV rehydration therapy (severe dehydration)

47
Q

How do you prevent rotavirus?

A

Prevent fecal-oral transmission

  • Sanitize toys
  • Handwashing
  • IgA in colostrums
  • Vaccines
48
Q

There are two types of the rotavirus vaccine. What are they?

A

There are two live, attenuated oral vaccines

  • Rotateq
  • Rotatrix
49
Q

What does Rotateq protect against?

A

Protective against G1-G4, G9

50
Q

What is the Rotateq vaccine a product of?

A

Product of reassortment between human and bovine rotaviruses

51
Q

What type of vaccine is the Rotatrix vaccine?

A

Live attenuated strain
of Human rotavirus
G1P1A[8]

52
Q

What is the current recommendation for rotavirus vaccination?

A

universal vaccination of

infants before 12 wks

53
Q

What is the norovirus?

A

A major contributor to foodborne illness in the US

54
Q

Is the norovirus common?

A

Yes, it causes 96% of outbreaks of nonbacterial gastroenteritis in the US

55
Q

What is the incubation period of the norovirus?

A

24-48 hours

56
Q

What symptoms do you see with the norovirus?

A
  • Nausea, vomiting and diarrhea for 24-60 hours

- Low grade fever in half of patients

57
Q

What age groups does the norovirus affect?

A

All age groups

58
Q

What is the pathology of the norovirus?

A

Similar to the rotavirus

59
Q

What virus family is the norovirus a member of?

A

The calicivirdae family

60
Q

Is the norovirus enveloped?

A

No

61
Q

What type of person does the norovirus show preference for?

A

Specific histo blood group antigens

62
Q

How large of an infectious dose is needed to cause a norovirus infection?

A

As little as 100 virions

63
Q

How is the norovirus transmitted?

A

Fecal-oral route

64
Q

What are the ways in which the fecal-oral route of transmission is accomplished?

A
  • Person to person (close contact, droplets from vomit)
  • Fomites
  • Water
  • Contaminated food (food handler, contamination prior to preparation)
65
Q

We commonly think of the norovirus being spread in schools, but it also spread ________

A

In long-term care facilities like nursing homes

66
Q

What type of genome does the adenovirus have?

A

dsDNA genome

67
Q

What are the unique features of the adenovirus

A
  • Naked capsid

- Fiber protein at vertices

68
Q

What serotypes of the adenovirus causes gastroenteritis?

A

40 and 41

69
Q

What is the incubation period for the adenovirus?

A

8-10 days

70
Q

What population do we typically see the adenovirus in?

A

Children primarily

71
Q

How is the virus shed?

A

Through the GI tract

72
Q

Is there seasonal variation in the adenovirus?

A

NO

73
Q

What are the symptoms of the adenovirus?

A
  • Watery, non-bloody diarrhea for 7-8 days

- May be accompanied by vomiting and fever

74
Q

How do you diagnose the adenovirus?

A

Antibody testing

75
Q

What is another virus of the Caliciviridea family that causes gastroenteritis?

A

Sapoviruses

76
Q

What are the “star-shaped” viruses that can also cause gastroenteritis?

A

Astroviruses

77
Q

What population is susceptible to the astrovirus?

A
  • Infants
  • Young children
  • Elderly
  • Healthy adults exposed to contaminated food or drink

Microbiology Exam 3 (8 decks)

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