Adenovirus and Poxvirus

Question 1

What does adenovirus cause?

Answer 1

Acute respiratory diseases and conjuctivitis

Question 2

Structure and location of replication for adenovirus

Answer 2

Double stranded non-enveloped DNA virus, replication in cell nucleus

Question 3

How many types of adenovirus are there and which type(s) cause most disease in children?

Answer 3

At least 42 types, most disease in children caused by types 1 and 2

Question 4

Three types of interactions adenovirus can have with a cell

Answer 4

Lytic infection, chronic (latent) infection, and oncogenic transformation (but NO EVIDENCE that adenovirus causes human neoplasms).

Question 5

How is adenovirus transmitted?

Answer 5

Inhalation of aerosol particles, or fecal-oral route

Question 6

Acute respiratory disease

Answer 6

Influenza-like symptoms, caused by adenovirus infection

Question 7

Pertussis-like syndrome

Answer 7

Relatively rare syndrome with whooping cough (similar to pertussis) caused by adenovirus infection

Question 8

What is the most common type of adenovirus disease in infants and young children?

Answer 8

Pharyngitis

Question 9

What virus causes pharyngitis?

Answer 9

Can be caused by type 1, 2, and 5 adenovirus

Question 10

Pharyngoconjuctival fever

Answer 10

Fever, conjuctivitis, pharyngitis, malaise. Can be caused by adenovirus infection

Question 11

Keratoconjuctivitis

Answer 11

Infection of cornea and conjunctiva, can be caused by adenovirus infection. Sudden onset of pain, photophobia, blurred vision, low fever, malaise, and upper respiratory symptoms

Question 12

Acute hemorrhagic cystitis

Answer 12

Inflammation of bladder resulting in gross hematuria, can be caused by adenovirus 11

Question 13

What is the second most common cause of serious viral gastroenteritis in young children?

Answer 13

Adenovirus serotypes 40 and 41

Question 14

How do we test for adenovirus?

Answer 14

Acute and convalescent phase serology to look for common group antigen using ELISA

Question 15

What is the structure of Pox viruses?

Answer 15

Large, double stranded DNA viruses

Question 16

Groups of pox viruses (3)

Answer 16

Orthopox, Tanapox, Parapox (smallest)

Question 17

What histopathological effect does varicella-zoster virus produce?

Answer 17

Intranuclear inclusions

Question 18

Describe the path varicella-zoster takes through the body

Answer 18

Enter through upper respiratory tract, taken to local lymph nodes, multiplies there, viremia to liver and spleen, secondary viremiea to epidermis, later ends up latent in nerves

Question 19

Spread of varicella-zoster

Answer 19

Direct contact, droplet, or airborne

Question 20

Incubation period and period of communicability for varicella-zoster (chicken pox)

Answer 20

Incubation is 10-23 days (2 weeks is typical), communicability for 5 days before eruption and not more than 6 days after last crop of vesicles appears

Question 21

What group of patients are at high risk for varicella-zoster complications and what should be given to these patients upon exposure?

Answer 21

Children with leukemia (7 to 10 percent mortality). Give VZIG

Question 22

Complications of chickenpox

Answer 22

Pneumonia (esp adults), CNS involvement (rare), secondary bacterial infection of broken skin, teratogenicity (esp if mother gets it early in pregnancy)

Question 23

Is there a vaccine for varicella virus? If so, what type is it?

Answer 23

Yes, it is a live virus vaccine

Question 24

Herpes Zoster is almost always diagnosed clinically. That said, what lab tests can be done to diagnosis this?

Answer 24

Viral culture (slow), Serological diagnosis with acute and covalescent phase sera (slow), PCR (faster)

Question 25

Prevention and treatment for Herpes Zoster

Answer 25

Special herpes zoster vaccine for prevention (even for those who have had chickenpox), treatment is acyclovir andor ganciclovir

Question 26

Two types of smallpox

Answer 26

Variola major (classical smallpox) and variola minor (alastrim, much less deadly than variola major)

Question 27

Differences between the lesions of smallpox and chickenpox

Answer 27

Distribution (smallpox lesions on face, arms, legs), smallpox has no second crop of lesions, smallpox lesions are deeper than chickenpox lesions

Question 28

Spread of monkeypox

Answer 28

Person to person - respiratory droplets, face to face contact, touching body fluids. Animal to person - bite, touch infected blood, body fluids, or rash

Question 29

What is ORF, who does it infect, and how is the diagnosis made?

Answer 29

A parapox virus, usually infects sheepherders, veterinaries, other animal handlers. Diagnosis made by electron microscopy

Question 30

Molluscum contagiosum

Answer 30

A pox virus which causes water warts (histologically inclusion bodies), and usually resolves spontaneously

Question 31

What DNA virus that causes skin infections makes a good viral vector for gene therapy?

Answer 31

Adenovirus

Question 32

Stages of pox lesions

Answer 32

Macular, papular, vesicular, scab (chickenpox you will have lesions in all phases together, true pox viruses all lesions go through stages together)