Childhood Viral Infections Flashcards
Name some notifiable diseases
-Acute meningitis
-Acute poliomyelitis
-Measles
-Mumps
-Rubella
-Smallpox
Report to public health England
When is IgM and IgG produced?
- IgM=Acute infection
- IgG=Long term immunity (some maternal antibodies IgA in breast milk)
Which viruses produce a rash?
- Parvovirus
- Measles
- Chickenpox
- Rubella
- Non-polio enterovirus infection
- EBV
- Bacterial (staph aureus, N.meningitidis)
Describe the measles virus, its infectivity, incubation period and how it is transmitted
- Paramyxovirus
- Enveloped single stranded RNA virus
- Person to person by droplet spread
- Infective from start of first symptom to end
- 7-18days
- Humans are the only natural host
What are the clinical features of Measles?
- Prodrome: Fever, malaise, conjunctivitis, cough, coryza
- Rash: Erythematous, maculopapular, head-trunk
- Koplik’s spots
What are complications of measles?
- otitis media
- pneumonia
- Diarrhoea
- Acute encephalitis- rare but fatal
- SSPE
How is measles diagnosed, treated and prevented?
D=Leukopenia, serology, oral fluid sample, clinical
T= Supportive, antibiotics for superinfection
P=Vaccine (MMR), human normal immunoglobulin
Describe the chickenpox virus, its transmission, its infectivity and its incubation period
- Varicella Zoster virus, Herpes virus-DNA virus
- Respiratory spread/personal contact
- 14-15days
- 2 days before onset of rash until after vesicles dry up
- Humans only host
What are the clinical features and complications of Chickenpox?
-Fever, malaise, anorexia
-Rash-Centripetal: macular>papular>vesicular>pustular
C=Pneumonitis (inc for smokers)
-CNS involvement
-Thrombocytopenic purpura
-Foetal varicella syndrome
-Zoster
-Congenital varicella
How is Chickenpox diagnosed, prevented and treated?
D=Clinical, PCR, serology (IgG in women)
T=Symptomatic for adults, Aciclovirorall, Chlorpheniramine
P=Vaccine(live), VZ immunoglobulin for inc risk of severe varicella
Describe Rubella, its transmission, infectivity and incubation period
- Togavirus, RNA virus
- Droplet spread/air-bourne
- 14-21 days
- One week before rash to 4 days after
What are the clinical features and complications of Rubella?
-Prodrome-non specific
-Lymphadenopathy-post auricular, suboccipital
-Rash: non-specific, transient, erythematous, behind ears, face & neck
C= thrombocytopenia, post infectious encephalitis, arthritis
-50% children asymptomatic
What are the problems associated with Rubella in pregnancy?
- Congenital Rubella Syndrome: cataracts/eye defects, deafness, cardiac abnormalities, microcephaly, retardation of intra-uterine growth, inflammatory lesions of brain, liver, lungs & bone marrow
- More severe when contracted early in pregnancy
- Foetal damage rare after 16 weeks only deafness reported
How is Rubella diagnosed and treated?
D=oral fluid testing (IgM/G), serology, IgM positive
T=non available, vaccine, immunoglobulin given to exposed pregnant women
Describe Parvovirus B19, its transmission, incubation period
- B19-DNA virus
- Respiratory secretions or mother to child
- 4-14days
- Risk of miscarriage in early pregnancy
- Foetal disease: anaemia, hydrops (foetal transfusion)
What are the clinical features of parvovirus B19?
- Minor respiratory illness
- Rash illness ‘slapped cheek’
- Arthralgia
- Aplastic anaemia
- Anaemia in immunosuppressed
How is Parvovirus diagnosed and treated?
D=Serology (IgM/G), amniotic fluid sampling, PCR in immunocompromised
T=blood transfusion, no vaccine/self-limiting, infection control
Describe Enteroviral infections
- Coxsackie, entero, echoviral infections
- Prevalent in under 5s
- 90% asymptomatic
- Faecal-oral route & skin contact
- Hand, foot & mouth disease
- Fever-rash syndromes
- Meningitis- PCR of CSF
- Supportive management
Describe Respiratory Syncytial Virus
- Pneumovirus
- Bronchiolitis (under 1, can be life-threatening, common reinfections, winter epidemic)
- Diagnosed by PCR on secretions from nasopharyngeal aspirate
- Treat by fluid intake, manage fever, O2
Describe Metapneumovirus
- Recently discovered
- Paramyxovirus
- Causes respiratory illness similar to RSV (mild->pneumonia)
- Supportive treatment
- Diagnosis by PCR
Describe Adenovirus
- Clinical disease, mild URTI, conjunctivitis, diarrhoea
- No treatment
- Diagnose by resp panel/eye swab PCR
Describe Parainfluenza
- Paramyxovirus
- 4 types (1winter, 3summer)
- Person to person transmission by inhalation
- Croup/URTI,bronchiolitis
- No treatment
- Diagnosis-multiplexed PCR
Describe Rhinovirus
- Common cold
- Member of picornaviridae
- Coronavirus/adenovirus/enterovirus have similar features
What are common diagnoses for children with diarrhoea
- Rotavirus
- Norovirus
Describe Rotavirus
- Reovirus (RNA virus)
- Faecal-oral route occasionally respiratory
- Low infective dose
- 1-2days
- Seasonal
What are clinical features of Rotavirus?
-Diarrhoea & vomiting
What is Norovirus?
- Winter vomiting bug
- Foodborne
- Person to person spread
- Short course 12-60hrs
- High incidence of vomiting
Describe Mumps, its transmission, infectivity and incubation
- Paramyxoviridae family
- Direct contact, droplet spread, fomites
- Several days before parotid swelling to several after
- 2-4weeks
What are the clinical manifestations of Mumps?
- Prodrome: non-specific, low grade fever, anorexia, malaise, headache
- 24hrs: earache, tenderness over ipsilateral parotid
- 2/3days: Gradual enlarging parotid w/severe pain
- pyrexia 40degrees
- Rare: oophoritis, meningitis, encephalitis, pancreatitis, epididymo-orchitis, submandibular/sublingual sialadenitis
How is mumps diagnosed and treated?
-Serology (blood, saliva)
Symptomatic, vaccine
