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Clinical Pathology > Childhood Viral Infections > Flashcards

Childhood Viral Infections Flashcards

1
Q

Name some notifiable diseases

A

-Acute meningitis
-Acute poliomyelitis
-Measles
-Mumps
-Rubella
-Smallpox
Report to public health England

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2
Q

When is IgM and IgG produced?

A
  • IgM=Acute infection

- IgG=Long term immunity (some maternal antibodies IgA in breast milk)

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3
Q

Which viruses produce a rash?

A
  • Parvovirus
  • Measles
  • Chickenpox
  • Rubella
  • Non-polio enterovirus infection
  • EBV
  • Bacterial (staph aureus, N.meningitidis)
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4
Q

Describe the measles virus, its infectivity, incubation period and how it is transmitted

A
  • 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
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5
Q

What are the clinical features of Measles?

A
  • Prodrome: Fever, malaise, conjunctivitis, cough, coryza
  • Rash: Erythematous, maculopapular, head-trunk
  • Koplik’s spots
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6
Q

What are complications of measles?

A
  • otitis media
  • pneumonia
  • Diarrhoea
  • Acute encephalitis- rare but fatal
  • SSPE
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7
Q

How is measles diagnosed, treated and prevented?

A

D=Leukopenia, serology, oral fluid sample, clinical
T= Supportive, antibiotics for superinfection
P=Vaccine (MMR), human normal immunoglobulin

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8
Q

Describe the chickenpox virus, its transmission, its infectivity and its incubation period

A
  • 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
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9
Q

What are the clinical features and complications of Chickenpox?

A

-Fever, malaise, anorexia
-Rash-Centripetal: macular>papular>vesicular>pustular
C=Pneumonitis (inc for smokers)
-CNS involvement
-Thrombocytopenic purpura
-Foetal varicella syndrome
-Zoster
-Congenital varicella

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10
Q

How is Chickenpox diagnosed, prevented and treated?

A

D=Clinical, PCR, serology (IgG in women)
T=Symptomatic for adults, Aciclovirorall, Chlorpheniramine
P=Vaccine(live), VZ immunoglobulin for inc risk of severe varicella

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11
Q

Describe Rubella, its transmission, infectivity and incubation period

A
  • Togavirus, RNA virus
  • Droplet spread/air-bourne
  • 14-21 days
  • One week before rash to 4 days after
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12
Q

What are the clinical features and complications of Rubella?

A

-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

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13
Q

What are the problems associated with Rubella in pregnancy?

A
  • 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
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14
Q

How is Rubella diagnosed and treated?

A

D=oral fluid testing (IgM/G), serology, IgM positive

T=non available, vaccine, immunoglobulin given to exposed pregnant women

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15
Q

Describe Parvovirus B19, its transmission, incubation period

A
  • B19-DNA virus
  • Respiratory secretions or mother to child
  • 4-14days
  • Risk of miscarriage in early pregnancy
  • Foetal disease: anaemia, hydrops (foetal transfusion)
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16
Q

What are the clinical features of parvovirus B19?

A
  • Minor respiratory illness
  • Rash illness ‘slapped cheek’
  • Arthralgia
  • Aplastic anaemia
  • Anaemia in immunosuppressed
17
Q

How is Parvovirus diagnosed and treated?

A

D=Serology (IgM/G), amniotic fluid sampling, PCR in immunocompromised
T=blood transfusion, no vaccine/self-limiting, infection control

18
Q

Describe Enteroviral infections

A
  • 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
19
Q

Describe Respiratory Syncytial Virus

A
  • 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
20
Q

Describe Metapneumovirus

A
  • Recently discovered
  • Paramyxovirus
  • Causes respiratory illness similar to RSV (mild->pneumonia)
  • Supportive treatment
  • Diagnosis by PCR
21
Q

Describe Adenovirus

A
  • Clinical disease, mild URTI, conjunctivitis, diarrhoea
  • No treatment
  • Diagnose by resp panel/eye swab PCR
22
Q

Describe Parainfluenza

A
  • Paramyxovirus
  • 4 types (1winter, 3summer)
  • Person to person transmission by inhalation
  • Croup/URTI,bronchiolitis
  • No treatment
  • Diagnosis-multiplexed PCR
23
Q

Describe Rhinovirus

A
  • Common cold
  • Member of picornaviridae
  • Coronavirus/adenovirus/enterovirus have similar features
24
Q

What are common diagnoses for children with diarrhoea

A
  • Rotavirus

- Norovirus

25
Q

Describe Rotavirus

A
  • Reovirus (RNA virus)
  • Faecal-oral route occasionally respiratory
  • Low infective dose
  • 1-2days
  • Seasonal
26
Q

What are clinical features of Rotavirus?

A

-Diarrhoea & vomiting

27
Q

What is Norovirus?

A
  • Winter vomiting bug
  • Foodborne
  • Person to person spread
  • Short course 12-60hrs
  • High incidence of vomiting
28
Q

Describe Mumps, its transmission, infectivity and incubation

A
  • Paramyxoviridae family
  • Direct contact, droplet spread, fomites
  • Several days before parotid swelling to several after
  • 2-4weeks
29
Q

What are the clinical manifestations of Mumps?

A
  • 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
30
Q

How is mumps diagnosed and treated?

A

-Serology (blood, saliva)

Symptomatic, vaccine

Clinical Pathology (56 decks)

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