Chapter 3.29 The Rest of the RNA Viruses Flashcards
What are arboviruses?
arthropod borne viruses- togaviridae, flaviviridae, bunyaviridae
What virus causes West Nile Virus?
flavavirus spread by mosquitos
What are picornviridae?
enteroviruses- poliovirus, coxsachie A and B, echovirus
*ENTERO = GI, fecal-oral transmission
What virus causes the common cold?
rhinovirus and coronaviridae
What virus causes SARS virus (Severe Acute Respiratory Syndrome)?
coronaviridae
What viruses cause diarrhea?
rotavirus and caliciviridae
What disease does rhabdoviridae cause?
rabies
What viruses cause hemorrhagic fever and are bioweapons?
Filoviridae group- Ebola, Marburg viruses
Arenaviridae group- Lassa Fever Virus
How are arboviruses transmitted?
blood-sucking arthropods that cause fever and encephalitis
What is the mneumonic for arboviruses?
paul BUNyan wearing a TOGA has a rick FLAVor that attracts mosquitos and other arthropods.
What are the 2 members of the togaviridae family?
alpha viruses- mosquito borne
rubivirus- causes rubella
What is the clinical presentation of a patient with alpha virus?
encephalitis, headache, altered consciousness, and focal neurologic damage
What do alpha viruses infect?
horses birds and humans using mosquitos as a vector
*causes encephalitis
What is the WEE virus?
Western Equine Encephalitis
*type of alpha virus
What is the EEE virus?
Eastern Equine Encephalitis
*type of alpha virus
What is the VEE virus?
Venezuelan Equine Encephalitis
*type of alpha virus
What mosquito-borne alpha virus does not cause encephalitis?
Chikungunya virus
What is the clinical presentation of a patient infected with Chikungunya virus?
fever, rash, *join pain/swelling
*the joint pain can last for a long time even though the rash and fever resolve after a few days
What are the characteristics of Rubivirus?
a type of togavirus but not a arbovirus because humans are the only infected creature
What virus causes rubella?
rubivirus
What is the clinical importance of rubivirus?
it can cross the placenta and cause congenital defects
What is the clinical presentation of a patient with rubella?
flu-like symptoms followed by red maculopapular rash that spreads from the forehead to face to torso to extremities
How is rabies transmitted?
respiratory secretions
How long does a rubella rash last?
3 days- “3 day measles”
How can rubella affect a fetus?
TORCHES- R is congenital rubella
causes congenital defects affecting the heart, eye, and CNS
What are the heart defects from rubella in a fetus?
patent ductus, interventricular septal defect, pulmonary artery stenosis
What are the eye defects from rubella in a fetus?
cataracts, chorioretinitis
What are the CNS defects from rubella in a fetus?
mental retardation, microcephaly, deafness
What are the vaccination tactics for rubella?
live attenuated rubella vaccine is given to all young children but not pregnant women
*if pregnant women do not have antibodies for rubella, they will receive immunization after delivery
What is St. Louis encephalitis?
encephalitis caused by flavivirdae
How is flavivirdae transmitted?
by mosquito
*infects humans and birds
What febrile diseases are caused by flaviviridae?
yellow fever and Dengue fever
What is the clinical presentation of a patient with yellow fever?
hepatitis with jaundice
fever, backache, nausea, vomiting
What is the clinical presentation of a patient with Dengue fever?
severe painful backache, muscle and join pain, and severe headache
*also called break-bone fever
How is West Nile Virus transmitted?
mosquito or bird
*mostly mosquito bites
What is the clinical presentation of patient with West Nile Virus?
*most patients are asymptomatic
symptomatic patients have wide range of symptoms- headache, rash, fatigue, weakness, decreased consciousness, motor paralysis… etc
How is West Nile Virus Diagnosed?
- Isolation in culture
- Serum IgM vs WNV with IgG antibodies
- CSF fluid IgM against WNV
- Serum antibody titers
What disease are caused by Bunyaviridae?
California encephalitis and Rift Valley fever
What is Hantavirus Pulmonary Syndrome?
influenza-like illness followed by sudden respiratory failure caused by hantavirus
What are the vectors for hantavirus that cause hantavirus pulmonary syndrome?
Rodents- ex. deer mouse
What is the clinical presentation of a patient with hantavirus pulmonary syndrome?
high fever, muscle aches, cough, nausea, vomiting
heart rate and respiratory rate are rapid
high WBC, low neutrophils
How is diagnosis of hantavirus pulmonary syndrome confirmed?
serologic identification of IgM and IgG antibodies against Sin Nombre Virus
How are the alveoli of the lung affected in hantavirus pulmonary syndrome?
fill with fluid and are unable to deliver oxygen to bloodstream
Who is most at risk for hantavirus pulmonary syndrome?
young adults with influenza-like symptoms who develop pulmonary edema
What are the 4 genera of picornaviridae?
enterovirus, rhinovirus, hepatovirus, and parechovirus
What are the 5 subgroups of Enterovirus?
poliovirus, coxsackie A virus, coxsackie B virus, echovirus, and rhinovirus
Why are enteroviruses grouped together?
infect intestinal epithelial and lymphoid cells
How are enteroviruses transmitted?
fecal-oral route
What cells can poliovirus infect?
Peyer’s patches of the intestine and motor neurons
What disease is associated with poliovirus?
paralytic poliomyelitis
*chances of developing poliomyelitis increases as one gets older
What are the 3 disease manifestations of polio?
- Mild illness- asymptomatic or mild febrile viral illness where sanitation is poor
- Asepetic meningitis- fever and meningismus if poliovirus infects meninges
- Paralytic poliomyelitis
What is the mechanism of paralytic poliomyelitis?
destruction of presynaptic motor neurons in anterior horn of spinal cord and postsynaptic neurons
What is the clinical manifestation of paralytic poliomyelitis?
peripheral motor neuron deficits and central motor neuron deficits
*flaccid paralysis ranging from 1 leg or arm to quadriplegia
What are the 2 vaccines for polio?
Inactivated polio vaccine- provoke IgG antibody response
Oral polio vaccine- attenuated poliovirus but can potentially cause vaccine-associated paralytic poliomyelitis
What can both coxsackie viruses, echoviruses, and new enteroviruses cause?
- Asymptomatic or mild febrile infections
- Respiratory symptoms “cold”
- Rashes
- Aseptic meningitis
What are the most common viruses that cause non-bacterial meningitis in the US?
enteroviruses
How can Coxsackie A be differentiated form Coxsackie B
*how they effect mice
Cox A- causes paralysis and death of mouse with extensive skeletal muscle necorsis
Cox B- less severe infection in mice but damage to heart, brain, liver, pancreas
What diseases can be caused by Coxsackie A?
Herpangina- self-limiting illness characterized by fever, sore throat, small red-based vesicles on back of throat
Hand, food, and mouth syndrome- child illness characterized by oral vesicles, fever, and small tender lesions on hands, feet, and buttocks
What diseases can be caused by Coxsackie B?
Pleurodynia- fever, headache, severe lower thoracic pain on breathing (pleuritic pain)
Myocarditis/Pericarditis- inflammation of heart muscle and pericardial membrane
How is Rhinovirus transmitted?
hand-to-hand spread of mucous membrane secretions
What virus causes SARS (severe acute respiratory syndrome)?
coronavirus
What is the mode of transmission for coronavirus?
direct or indirect contact of mucous membrane (eyes, nose or mouth) with infectious respiratory droplets
What is the clinical presentation of a patient with SARS?
initial- fever, myalgias, chills
later- dry cough, chest pain, shortness of breath
What is on the chest X-ray of a patient with SARS?
alveolar consolidation
Who is most susceptible to viruses that cause diarrhea?
infants and young children through fecal-oral route
What are the 4 groups of viruses that cause diarrhea?
caliciviruses (+ Norwalk virus), rotaviruses, adenoviruses, and astroviruses
Who does caliciviridae primarily infect?
young children and infants
causes diarrhea, vomiting and fever
*indistinguishable from gastroenteritis caused by rotavirus
Who does Norwalk virus occur in?
adults that develop diarrhea and severe vomiting
What are the characteristics of Norovirus?
cause of acute infectious diarrheal outbreaks
ex. on cruise shops or after hurricane katrina
What family is rotavirus in?
reovirus
What does rotavirus cause?
acute infectious diarrhea and major cause of infant mortality
What are the characteristics of astroviruses?
periodic outbreaks of diarrhea in infants, children, and elderly
Who is susceptible to rabies virus?
all warm-blooded animals with dogs, cats, skunks, coyotes, foxes, raccoons and bats serving as reservoirs
What is the clinical presentation of rabies?
encephalitis
fearless, aggressive, and disoriented behavior
What occurs when a human is infected with rabies?
migrates to axons of CNS and causes fatal encephalitis
What is specifically present in brain cells when infected with rabies?
Negri bodies- collection of virions
What occurs during the prodrome stage of rabies?
nonspecific symptoms- fever, headache, sensitive nerves around wound site
*muscles around site may fasciculate
What occurs during the acute encephalitis phase of rabies?
hyperactivity and agitation lead to confusion, meningismus, and seizures
What occurs in during classic brainstem encephalitis in rabies?
brainstem infection causing cranial nerve dysfunction and painful contraction of pharyngeal muscles
*foaming of the mouth
How does death occur from rabies?
secondary to respiratory center dysfunction
What viruses cause hemorrhagic fever?
Filoviridae- ebola and marburg viruses
Arenaviridae
What are the initial symptoms of Ebola?
abrupt onset of fever, chills and malaise
What occurs in the first few days of Ebola?
nausea, vomiting, diarrhea, and abdominal pain
When does a rash form in Ebola?
5-7 days
What occurs in the GI tract from Ebola?
hemorrhage
How is Ebola diagnosed?
detection of viral antigens or RNA in blood
What is the thought transmission of Ebola?
direct contact with bodily fluids- mostly blood, vomit, urine, stool or semen from living or dead patient
*could potentially be airborne
What viruses are included in Arenaviridae?
Lassa Fever virus and 4 Hemorrhagic Fever Viruses
What are the 4 hemorrhagic fever viruses?
Junin virus, Machupo virus, Guanarito virus, and Sabia virus
What is the main mode of transmission for Lassa Fever and the 4 Hemorrhagic fever viruses?
direct contact and droplet spread
What do Rift Valley Fever and Yellow fever cause?
hemorrhagic fever- suspected to have been weaponized
*may be transmitted through aerosolization