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Virology > Arboviruses 2 (WNV, Dengue, YF, Toga) > Flashcards

Arboviruses 2 (WNV, Dengue, YF, Toga) Flashcards

1
Q

4 hallmarks of WNV

A

Menigitis

Encephalitis

Mengingoencephalitis

PolioMyelitis

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2
Q

Three conditions of WN encephalitis?

A

Asymptomatic infection

West Nile Fever

Neuroinvasive disease

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3
Q

About __% of West Nile infections are asymptomatic

A

80%

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4
Q

About __% of patients develop West Nile Fever, from which most people ____

A

20%, Recover

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5
Q

West Nile Fever lasts about ______ days

A

3-6

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6
Q

Hallmark for CNS disease from West Nile VIrus? How many patients progress to this stage?

A

Erythematous maculopapular or morbilliform rash

Less than 1%

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7
Q

WNV infects ____ cells

A

Langerhans Dendritic

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8
Q

WNV vauses primary viremia after migrating to ______

A

lymph nodes

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9
Q

Does WNV cause 2’ viremia?

A

Yes

After dissemination to RE system

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10
Q

_____ limits WNV dissemination to the CNS

Patients that progess past this point may have less robust ___ response

A

Antibodies

IgM

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11
Q

_____ results in WNV clearance from infected neurons

A

CD8 T cell response

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12
Q

WNV major vector and intermediate host

A

Mosquito Vector

Bird intermediate host

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13
Q

Other than mosquito to man, what are other ways we can and can NOT get WNV?

A

No: Man to man or animal to man

Yes: Live or dead bird, consumption of infected bird

Other: Blood transfusions, organ transplants, lab exposure, or from Mom > Baby

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14
Q

WNV vaccines are approved for ___

A

Equine use

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15
Q

Dengue Serotypes

A

1-4

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16
Q

Increased _______ helps in spreading Dengue

A

air travel

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17
Q

Explain the Dengue infection in terms of serotypes and immunity

A

If infected with one, it does not provide protection against the other three

It actually increases the severity of subsequent Dengue infections

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18
Q

Dengue presents ___ days after bite

A

3-15

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19
Q

Does Dengue cause a fever?

A

Yes - saddleback fever up to 106 degrees

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20
Q

Most people recover from Dengue within _____

A

one week

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21
Q

Two Dengue Clinical presentations (syndromes)

A
  1. Dengue Hemorrhagic Fever (DHF)
  2. Dengue Shock Syndrome (DSS)
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22
Q

Most DHF patients are how old?

A

under 15 years

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23
Q

Characteristic manifestations of DHF

A
  • Plasma leakage
  • bleeding from trauma sites
  • GI bleed
  • Hematuria
  • Seizures and CNS symptoms
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24
Q

What is DSS?

A

Dengue shock syndrome - it is untreated DHF that has progressed to circulatory failure

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25
Q

Dengue targets what cells?

A

Langerhans (dendritic) cells

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26
Q

Dengue pathogenesis (6 steps)

A
  1. infects langerhans
  2. APC to T cells
  3. Enter Monocyte/endothelial cells, attacked by CD4/CD8 and cytokines
  4. **activates **immune system
  5. increases vascular permeability (plasma leaks)
  6. Hemoconcentration and hypovolemic shock occur
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27
Q

Dengue is enhanced in an __________ fashion

A

antibody-dependent

*they aid virus in getting into cells

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28
Q

sEach DENV (Dengue) serotype has the ability to cause _______ infections

A

ALL TYPES

(asymptomatic, DF, DHF, DSS)

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29
Q

______ are most affected by Dengue

A

Children

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30
Q

Dengue in US occurs primarily in ___________________

A

travelers from endemic areas

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31
Q

Dengue mainly spread by ______

A

Aedes aegypti mosquito

32
Q

Can dengue be transmitted from human to human?

A

YES

33
Q

Primate cycle of transmission is called ________

A

Sylvatic / Enzoonotic

34
Q

Dengue control and treatment

A

No treatment (supportive therapy only)

Immunization is hard because of SEROTYPES

35
Q

Yellow Fever stages

A

Initial symptoms

Toxic Stage

Late Stages

36
Q

YF initial symptoms

A

abrupt flu like symtoms (with fever)

37
Q

YF toxic phase develops after…

A

initial remission of symptoms and fever

38
Q

YF toxic phase hemorragic manifestations are caused by…

A

hepatic induced coagulopathy.

causes hematemesis, epistaxis, gingival bleeding and petechial hemorrhages

39
Q

YF toxic phase - systemic manifestations?

A

jaundice and albuminuria

40
Q

Late stage YF manifestations

A
  • Hypotension, shock
  • Metabolic Acidosis
  • Acute Tubular Necrosis
  • Heart dysfunction and arrhythmia
41
Q

What distinguishes the CNS symptoms of the late stages of YF?

A

Confusion

seizure

Coma

42
Q

________ are complications in patients who survive late-stage YF

A

Secondary bacterial infections

43
Q

YF replicates initially at ___________

A

local lymph nodes

44
Q

Where does YF spread to once initial infection occurs?

A

First to other lymph tissue, spleen and bone marrow

Then to liver, lungs, and adrenals

45
Q

Most important organ affected by YF?

A

Liver

46
Q

______ form in the liver during YF

A

Councilman bodies

(apoptotic hepatocytes)

47
Q

2nd most affected organ by YF?

What systemic changes result from this?

A

Kidney

Albuminuria and renal insufficiency

48
Q

YF hemorrhage is from reduced _________ and can result in _________

A

reduced clotting factor production by liver

Results in: Hematemesis, thrombocytopenia, and platelet dysfunction

49
Q

The terminal event of YF is _____.

What two things can this be attributed to?

A

shock

from direct parenchymal damage and systemic inflammatory response

50
Q

Almost everyone that enters the toxic stage of YF…

A

progresses to the late (third) stage

51
Q

Yellow Fever Vaccine properties/dosage

A

Vaccine = Live attenuated (Stamaril)

Single dose gives 100% immunity for 10 years

single SubQ injection

52
Q

The arboviral togaviridae are…

A

Alphaviruses

EEEV, WEEV, VEEV

53
Q

Alphavirus genome structure

A

ss+RNA

Enveloped

Icosahedral capsid

54
Q

Alphavirus has ______ for attachment

A

glycoprotein spikes

but NO receptor is known!!

55
Q

Alphavirus replication occurs in _____

A

cytoplasm

56
Q

Alphavirus parental ___ RNA strand encodes ______.

The resulting molecule is re-coded into _______.

This RNA is made into ___ and _____.

This results in production of ______.

A

parental +RNA makes Nonstructural proteins in 5’ end

Molecule recoded into (-) RNA

Made into progeny +RNA is made into +mRNA

This results in production of progeny virus

57
Q

EEE has a ____ period first

A

Prodromal

58
Q

EEE progresses more rapidly to _____ and ______

A

CNS and death

59
Q

CNS symptoms of EEE

A

General (headavhe, nausea, confusion)

Focal defecits (sensory/motor loss, seizures, stiff neck, cranial nerve palsies, photophobia)

60
Q

Pathogenesis of EEE

A

mosquito injects virus subQ

Non-CNS replication during prodrome

2’ viremia = CNS invasion

immune cells enter brain and damage

Gross inspection = edema, vascular congestion, hemorrhage, ENCEPHALOMALACIA

61
Q

Equine Encephalitis’ resevoirs

A

Mosquitos, Birds (WEE and EEE)

Rodents (VEE)

*also amphibians and reptiles

62
Q

Incidence of EEE

A

only 5% of EEEV results in EEE

63
Q

What happens immunologically after EEEV infection?

A

lifelong immunity

64
Q

EEEV most common in ____ United States

A

Southeastern

65
Q

WEE incubation time

A

Short (1-4 days)

66
Q

Initial WEE symptoms are…

A

flu-like

subclinical in many people

67
Q

WEE Neuro symptoms indicate

A

poorer prognosis

Symptoms similar to EEE (Focal defecits, seizures, neck stiffness and photophobia)

68
Q

________ is rarer in WEE than EEE

A

cranial nerve palsy

69
Q

WEE is most common during

A

Summer months (April - September)

70
Q

VEE presentation can be ___, ___, or ___

(with symptoms)

A

MILD (flulike)

MODERATE (+ photophobia back pain, fever)

SEVERE (acute high fever, severe myalgia and back pain, photophobia, prostration, confusion)

71
Q

In Alphavirus, ____ and ____ are dead end hosts

A

humans and horses

72
Q

Alphavirus can be transferred to mosquitos from ____

A

Birds

73
Q

Alphavirus control is based on _______

A

disease surveillance

74
Q

Vaccine for Alphavirus? Who is it used for?

A

Inactivated vaccine

used for lab workers

75
Q

What vaccine has been used for Alphavirus in horses?

A

live-attenuated VEE vaccine

*similar one used for lab workers

Virology (13 decks)

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