CA - Virology (CKL) Wk 5 Flashcards
Varicella Zoster Virus (VZV/Chickenpox)
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms of unvaccinated patients:
1. generalised and pruritic (red itchy) rash
- progresses rapidly from macular to papular to vesicular lesions (fluid filled sacs) before crusting (dried up)
- Lesions are typically present in all stages of development at the same time
Symptoms of vaccinated patients:
1. Afebrile/low fever
2. < 50 skin lesions
3. shorter illness compared to unvaccinated people
4. rash is more likely to be maculopapular rather than vesicular
How does it spread?
1. Direct contact with person
2. Inhale aerosols from vesicular fluid of skin lesions of acute varicella or zoster
3. through infected respiratory secretions
Is it serious?
- Before vaccines yes
- Now no. Less than 30 deaths.
Varicella Zoster Virus (VZV/Chickenpox)
Consequence on foetus/baby if infected during pregnancy?
Any treatment? - Yes or No only
Is vaccine available?
Consequences:
- Last few days before birth: life threatening
Treatment: Yes
Vaccine: Yes
Hand foot mouth
How does the infection present clinically?
How isit spread?
Is it serious - why? What can happen to the pt?
Symptoms:
1. Fever, sore throat
2. Mouth sores
3. Skin rash, blisters
Spread through contact with:
1. Droplets with virus particles made after person sneezes, coughs, or talks
2. Objects and surfaces that have virus particles
3. Fluid from blisters
4. Poop
Is it serious?
No.
- Self-limiting, 7 -10 days with little to no medical treatment
Hand foot mouth disease
Any treatment? - Yes or No only
Is vaccine available?
Treatment: Yes
Vaccine: No
Hep A
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Dark urine or clay-colored stools
2. Diarrhea
3. Fatigue
4. Fever
5. Joint pain
6. Loss of appetite
7. Nausea, right side abdomen pain, vomiting
8. Jaundice
Spread:
1. Fecal-oral
2. Food & water
3. Person to person / Sex
Is it serious? No.
- Self-limiting.
- No long term liver damage
Hep A
Any treatment? - Yes or No only
Is vaccine available?
Treatment: No
Vaccine: Yes
Hep B
Consequence on foetus/baby if infected during pregnancy?
Any treatment? - Yes or No only
Is vaccine available?
Consequences on foetus/baby if infected during pregnancy?
- 90% of chronic HBV infection if infected perinatally
- increased risk of liver cirrhosis, hepatocellular carcinoma in adulthood
Treatment: Yes
Vaccine: Yes
Hep B
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Dark urine or clay-coloured stools
2. Fatigue
3. Fever
4. Joint pain
5. Loss of appetite
6. Nausea, right side abdomen pain, vomiting
7. Jaundice
Spread through:
1. Person to person
2. Blood, body fluids, sex
3. IV drug abuse
Is it serious?
~ 10% will progress to chronic Hep B
- can be severe if chronic
Hep C
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
- usually not symptomatic
- if have: Mild, vague symptoms
Spread:
1. Person to person
2. Blood, body fluids
3. IV drug abuse
4. Sex (rare)
5. Higher risk with HIV infections
Is it serious?
- Yes. > 70% of acute cases progress to chronic hepatitis
- Requires liver transplant
Hep C
Consequence on foetus / baby if infected during pregnancy?
Any treatment? - Yes or No only
Is vaccine available?
Consequence on foetus / baby if infected during pregnancy?
- Chronic HCV infection, risk of liver disease later in life
Treatment: Yes
Vaccine: No due to high genetic variability of virus
Hep E
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Dark urine or clay-coloured stools
2. Fatigue
3. Fever
4. Joint pain
5. Loss of appetite
6. Nausea, right side abdomen pain, vomiting
7. Jaundice
How is it spread?
1. Fecal oral
2. Contaminated water & food
3. Usually in developing countries
Is it serious?
- Usually mild but can be fatal in pregnancy
- Fulminant hepatitis in pregnancy = life-threatening condition that causes the liver to fail rapidly
Hep E
Consequence on foetus / baby if infected during pregnancy
Any treatment? - Yes or No only
Is vaccine available?
Can cause liver failure, fetal loss & death in pregnancy
Treatment: No
Vaccine: No
Measles
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. High fever
2. Cough, runny nose
3. Red watery eyes
4. Tiny white spots inside the mouth
5. Rash
How is it spread?
1. Contact with infected person - cough, sneeze, aerosolised (droplets dispersed into the air)
Is it serious?
Yes for babies, pregnant women, immunocompromised patients
Measles
Consequence on foetus / baby if infected during pregnancy?
Any treatment? - Yes or No only
Is vaccine available?
Consequence on foetus / baby if infected during pregnancy?
- Increased risk of miscarriage, preterm birth, stillbirth
- Severe neonatal measles if infected near delivery
- No specific congenital defects, but maternal pneumonia is life-threatening
Treatment: No
Vaccine: Yes
Mumps
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Pain, tenderness, swelling in 1 or both parotid salivary glands
How is it spread?
1. Person-to-person through direct contact with saliva or respiratory droplets of infected person
Is it serious?
Before vaccine yes.
Now with vaccine no.
Mumps
Any treatment? - Yes or No only
Is vaccine available?
Treatment: No
Vaccine: Yes
Rubella
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms: may occur 1 to 5 days before the rash appears:
1. Low-grade fever, Headache
2. Mild pink eye (redness or swelling of the white of the eye)
3. General discomfort
4. Swollen and enlarged lymph node
5. Cough, Runny nose
How is it spread?
1. Infected person coughs / sneezes
2. Pregnant mother to fetus
Is it serious?
YES for developing baby. Esp in 1st trimester.
Rubella
Consequence on foetus / baby if infected during pregnancy?
Any treatment? - Yes or No only
Is a vaccine available?
Consequence on foetus / baby if infected during pregnancy?
1. Unvaccinated: Miscarriage or baby die after birth
2. Pass virus to developing baby -> heart & liver / spleen damage, loss of hearing & eyesight, intellectual disability
3. Highest risk if infected in 1st trimester
Treatment: No
Vaccine: Yes
Common cold:
Any treatment? - Yes or No only
Is vaccine available?
Treatment: No
Vaccine: No
Common cold
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Runny nose, nasal congestion, Sneezing
2. Cough, Sore throat
3. Headache, fever
4. Mild body aches
How is it spread?
1. Person to person - aerosolised
2. Personal contact
Is it serious?
Yes for infants, elderly or immunocompromised pts
COVID-19
Any treatment? - Yes or No only
Is vaccine available?
Treatment: Yes
Vaccine: Yes
COVID-19
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Fever, Headache, chills
2. Cough, Sore throat, Congestion, runny nose
3. SOB/difficulty breathing
4. Sore throat
5. Congestion or runny nose
6. New loss of taste or smell
7. Fatigue, Muscle, body aches
8. Nausea or vomiting, Diarrhoea
How is it spread?
1. Aerosols, coughing, sneezing, talking
2. Direct contact
Is it serious? Yes
Respiratory syncytial virus RSV
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Runny nose, Congestion, Sneezing, Coughing, Wheezing
2. Decrease in appetite
3. Fever
How is it spread?
- person-to-person contact
- aerosolised droplets
Is it serious?
Can be deadly for infants, elderly, and immunocompromised patients.
Influenza
Any treatment? - Yes or No only
Is vaccine available?
Treatment: Yes
Vaccine: Yes
Influenza
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. fever, feeling feverish/chills
2. cough, sore throat, runny or stuffy nose
3. muscle or body aches
4. headache, fatigue
5. may have vomiting & diarrhea
How is it spread?
- person-to-person contact
- aerosolised droplets
Is it serious?
Yes for elderly, pregnant women, people with chronic diseases.
Complications: Pneumonia, myocarditis, respiratory failure, bacterial superinfection.
Cytomegalovirus CMV
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
In healthy people
Sometimes, infection in healthy people can cause mild illness like:
Fever
Sore throat
Fatigue
Swollen glands
Occasionally, CMV can cause mononucleosis or hepatitis (liver problems).
In people with weakened immunity
If you have a weakened immune system and get CMV, you can have more serious symptoms affecting the eyes; lungs; liver; esophagus; stomach; and intestines.
How is it spread?
From direct contact with saliva or urine, especially from babies and young children
Through sexual contact
During pregnancy, From breast milk to nursing infants
Through transplanted organs and blood transfusions
Is it serious?
Dangerous for newborns & immunocompromised
RSV
Any treatment? - Yes or No only
Is vaccine available?
Treatment: No. Self-limiting.
Vaccine: Yes
Cytomegalovirus CMV
Consequence on foetus / baby if infected during pregnancy?
Any treatment? - Yes or No only
Is vaccine available?
Consequence on foetus / baby if infected during pregnancy?
1. Congenital CMV → Sensorineural hearing loss (most common cause), intellectual disability, vision problems
2. Microcephaly, seizures, hepatosplenomegaly, jaundice, blueberry muffin rash
Treatment: Yes
Vaccine: No
Epstein-Barr Virus EBV
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
1. Fatigue, Fever
2. Inflamed throat, Swollen lymph nodes in the neck
3. Enlarged spleen, Swollen liver
4. Rash
How is it spread?
1. Saliva, bodily fluids, blood transfusions,
2. organ transplantations
Is it serious?
No
Epstein-Barr Virus EBV
Any treatment? - Yes or No only
Is vaccine available?
Treatment: No
Vaccine: No
Zika
How does the infection present clinically?
How isit spread - touch / saliva / airborne etc
Is it serious - why? What can happen to the pt?
Symptoms:
- Most are asymptomatic
- Some: fever, rash, headache, joint, muscle aches, red eyes
How is it spread?
1. bite of an infected Aedes species mosquito. It can also be spread through sex from a person who is infected with Zika virus to their sexual partner(s).
- Pregnant woman to baby
- Bodily fluids, sex
- Through infected blood, tissue, or laboratory exposures
Is it serious?
Only for pregnancy, can cause microcephaly (severe brain damage).
Zika
Consequence on foetus / baby if infected during pregnancy - this applies especially to CMV, VZV, Measles, Rubella, Hep B & C, HIV, HSV, CMV
Any treatment? - Yes or No only
Is vaccine available?
In pregnancy, can cause microcephaly (severe brain damage).
Treatment: no
Vaccine: no
What blood tests are requested for assessment of Dengue?
- White cell count WCC
- usually low in dengue due to viral suppression of bone marrow. - Platelet
- Dengue affects the bone marrow -> low platelet - Baseline Haematocrit (HCT)
= concentration of RBCs in the blood
- severe dengue -> high HCT due to fluid loss
What are the diagnostic tests for Dengue?
- PCR to look for Dengue virus (send blood in FBC blood tube)
- Best for early diagnosis - Serum for POCT (Dengue Duo)
- detects active dengue - Serum for Dengue antibody testing
- Confirms dengue after the first week of illness.
What cells do HIV affect?
CD4 T cells in the lymph nodes
How do you diagnose HIV?
FIRST LINE!
- Antibody + p24 antigen combined screening test
How do you manage HIV?
- No vaccine, only lifelong HAART treatment
- highly active antiretroviral therapy to suppress HIV replication - Antibiotic prophylaxis (preventative)
- against opportunistic infections - Cant be killed
