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Clinical Pathology > 6 - Childhood Viral Infections > Flashcards

6 - Childhood Viral Infections Flashcards

1
Q

What diseases would you report for to PHE?

A

Acute meningitis
Acute poliomyelitis
MMR
Smallpox

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2
Q

IgM is made when

A

Acute infection

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3
Q

IgG is made when

A

long term immunity

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4
Q

Which Ig from breast milk

A

IgA

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5
Q

Measles - virus

A

Paramyxovirus - enveloped single stranded RNA virus

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6
Q

Measles - transmission

A

Person to person

Droplet spread

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7
Q

Measles - infectivity

A

From start of first symptoms to after rash

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8
Q

Measles - incubation

A

7-18 days average = 10-12

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9
Q

Measles - clinical features

A

Prodrome: Fever, malaise, conjunctivits, coryza and cough (3 c’s)
Rash: erythematous, maculopapular, head-trunk
Koplik’s spots 1-2 days before rash

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10
Q

Measles - diagnosis

A

Clinical
Leukopenia
Oral fluid sample
Serology

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11
Q

Varicella noster virus: virus type

A

Herpes virus - DNA virus

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12
Q

Varicella noster virus: transmission

A

Respiratory spread / personal contact (face to face/ 15mins)

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13
Q

Varicella noster virus: incubation period

A

14-15 days

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14
Q

Varicella noster virus: infectivity

A

2 days before onset of rash until after vesicles dry up

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15
Q

Varicella noster virus: clinical features

A

Fever, malaise, anorexia
Rash - centripetal - macular > papular > vesicular > pustular

Complications: pneumonia, CNS involvement, thrombocytopenic purpura, foetal varicella syndrome, congenital varicella, zoster

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16
Q

Varicella noster virus: diagnosis

A

Clinical via PCR of vesicle fluid/CSF

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17
Q

Varicella noster virus: serology

A

Immunity

IgG in pregnant women in contact with ZVZ and no history of chickenpox

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18
Q

Varicella noster virus: treatment

A

Symptomatic adults and immunocompromised children
Aciclover oral, IV in severe disease or neonates
Chlorpheniramine can relieve itch (>1yo)

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19
Q

Varicella noster virus: prevention

A

Vaccine - live

For healthcare workers + immunocompromised

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20
Q

Varicella noster virus: when would you give VZ Ig?

A

Significant exposure
Clinical condition that increases risk of severe varicella e.g. pregnant, neonates
No Ab to VZ virus
Ig does not prevent infection, reduces severity

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21
Q

Rubella: virus

A

Togavirus

RNA virus

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22
Q

Rubella: transmission

A

Droplet spread - air-bourne, less contagious

23
Q

Rubella: incubation period

A

14-21 days

24
Q

Rubella: infectivity

A

One week before rash to 4 days after

25
Q

Rubella: clinical features

A

Prodrome - non-specific
Lymphadenopathy
Rash - non-specific

Complications: thrombocytopenia, post-infectious encephalitis, arthritis

50% of infectious children are asymptomatic

26
Q

Rubella: in pregnancy

A

Congenital rubella syndrome (CRS)

27
Q

What is CRS?

A

Congenital rubella syndrome?

Cataracts + eye defects, deafness, cardiac abnormalities, microcephaly, retardation of intra-uterine growth, inflammatory lesions of brain, liver, lungs and bone marrow

Severity based on weeks into pregnancy

28
Q

Rubella: diagnosis

A

Oral fluid testing - IgM/G (PCR if within 7 days of rash)

29
Q

Rubella: serology

A

IgM and IgG. Antibodies detectable from time of rash

30
Q

Rubella: treatment

A

No treatment available

Ig given to exposed pregnant women

31
Q

Rubella: prevention

A

Initially 11-14 yo.

Now part of MMR

32
Q

Erythema infectiosum: virus

A

Parvovirus B19 - slapped cheek virus

DNA virus

33
Q

Erythema infectiosum: transmission

A

Respiratory secretions from mother to child

34
Q

Erythema infectiosum: incubation

A

4 to 14 days

35
Q

Erythema infectiosum: symptoms

A

Risk of miscarriage in early pregnancy - but low
Asymptomatic in 20%
Foetal disease: anaemia;
Hydrops (foetal transfusion)

36
Q

Erythema infectiosum: clinical features

A 
Minor resp illness
Rash (slapped cheek)
Arthralgia
Aplastic anaemia
Anaemia in the immunosuppressed
37
Q

Erythema infectiosum: diagnosis

A

Serology IgM/IgG
Amniotic fluid sampling
PCR is immunocompromised

38
Q

Erythema infectiosum: treatment

A

None if self-limiting illness
Blood transfusion
No vaccine

Prevention: relies on infection control

39
Q

Enteroviral infection e.g.

A

Coxsackie
Entero
Echoviral infections

40
Q

Enteroviral prevalence

A

Worldwide, prevalent in under 5 yo

41
Q

Enteroviral symptoms and transmission

A

90% asymptomatic

Transmission is faecal-oral and skin contact

42
Q

Enteroviral diseases

A

Hand, foot and mouth
Fever, rash syndrome
Meningitis - PCR of CSF

43
Q

Viruses associated with respiratory symptoms

A 
Respiratory syncytial virus
Parainfluenza
Influenza
Adenovirus
Metapneumovirus
Rhinovirus
44
Q

What is respiratory syncytial virus?

A

Aka RSV

Pneumovirus, bronchiolitis (

45
Q

What is metapneumovirus?

A 
Paramyxovirus
Nearly universal by aged 5
Respiratory illness similar to RSV
Dx - PCR
Rx - supportive only
46
Q

What is adenovirus?

A

10% of childhood resp infection
Clinical disease: mild URTI, conjunctivitis, diarrhoea

Dx: resp panel PCR, eye swab PCR, serology possible

Rx: None/cidofovir if immunocompromised

47
Q

Parainfluenza

A

Paramyxovirus
Transmission: person-to-person, inhalation

Clinical: croup, bronchioltis, URTI

Dx: multiplexed PCR
Rx: None

48
Q

Rhinovirus

A

Member of picornaviridae
Found in 70% with mild URTI
Similar clinical features

49
Q

Rotavirus features

A 
RNA virus
Transmission: faecal-oral + occasionally resp
Low infective dose
Incubation: 1-2days
Epidemiology: seasonal in UK
50
Q

Rotavirus clinical features

A

Diarhoea and vomiting
6/12 - 2 yrs
Severe disease
Increased mortality in poorer countries

Dx: PCR
Rx: Rehydration
Prevention: oral live vaccine

51
Q

Norovirus

A 
Winter vomiting bug
Outbreaks
Foodbourne
Person-to-person
High incidence of vomiting (>50%)
Short course - 12-60 hrs
Dx: PCR
Rx: Rehydration
52
Q

Mumps features

A

Paramyxoviridae virus
Transmission - direct contact, droplet, fomites
Infectivity - several days before parotid swelling to several days after
Incubation - 2-4 weeks

53
Q

Mumps clinical features

A

Prodrome e.g. low-grade fever, anorexia, malaise and headache
24 hrs - earache, ipsilateral parotid
2-3 days - gradually enlarging parotid with severe pain
Pyrexia up to 40 degrees

Clinical Pathology (65 decks)

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