Childhood viral infections Flashcards
What six conditions are childhood viral infections which are notifiable to public health.
- Acute meningitis
- Acute poliomyelitis
- Measles
- Mumps
- Rubella
- Smallpox
Which antibody levels are high in acute infection
IgM
Which antibody levels are high in chronic infection
IgG
Which antibody is maternal
IgG
Which antibody is present in breast milk
IgA
what type of virus is measles
Paramyxovirus
How is measles transmitted
droplet spread- person to person.
What time periord is infectivity of measles.
from the start of the first symptoms (4 days) before rash to 4 days after disappearance of rash.
What time period is incubation of measles
– 7-18 days (average 10-12)
Clinical features of measles
Prodrome- – Fever, malaise, conjunctivitis, coryza and cough
Kopliks spots
fever
rash- head to trunk
Complications of measles
ottits media
Pnemoniae
Diarrhoea
acute encephalitis
How do you diagnose measles
- Leukopenia
- Oral fluid sample
- Serology
What is the treatment for measles
supportive and antibiotics.
Prevention methods for measles
Vaccine
1 year old and before pre school.
What is the medical name for chicken pox
Varicella zoster virus.
What are chicken pox transmitted
– Respiratory spread/personal
– Contact (face to face/15mins)
what is the incubation period for chickenpox
14-15 days
What is the infectivity period for measles
2 days before onset of rash until after vesicles dry up.
Clinical features of VZV
Fever, malaise, anorexia
Rash – centripetal- directed towards the centre.
Complications of VZV
– Pneumonitis (risk increased for smokers)
– Central nervous system (CNS) involvement
– Thrombocytopenic purpura
– Foetal varicella syndrome
– Congenital varicella
Diagnosis/Treatment of VZV
PCR –vesicle fluid/CSF
Can use swab.
Serology
Treatment of VZV
– Aciclovir oral, IV in severe disease or neonates.
– Chlorpheniramine can relieve itch
Prevention of VZV
Vaccine- 2 live doses VZ Immunoglobulin (VZIG)
What type of virus is rubella
Toga, RNA virus.
How is rubella transmitted
Droplet spread – air-borne
What is the incubation period of rubella
14-21 days
What is the infectivity period of rubella
– One week before rash to 4 days after.
What ar the clinical features of rubella
- Prodrome – non-specific e.g. tiredness, fever, headache.
- Lymphadenopathy – post-auricular, sub occipital
- Rash- spreads from the face
Complications of rubella.
– Thrombocytopenia;
– Post-infectious encephalitis; arthritis.
– Mild self-limiting infection not too dangerous in immunosuppressed.
What syndrome occurs as a result of rubella in pregnancy
Congenital rubella syndrome (CRS)
Characteristics of Congenital rubella syndrome
– Cataracts and other eye defects
– Deafness
– Cardiac abnormalities
– Microcephaly
– Retardation of intra-uterine growth
– Inflammatory lesions of brain, liver, lungs and bone marrow.
more severe is contracted in early pregnancy.
Diagnosis of rubella
- Oral fluid testing – IgM/G (PCR if within 7 days of rash).
* Serology – IgM and IgG. Antibodies detectable from time of rash.
What treatment is there for rubella.
• No treatment available – immunoglobulin given to exposed pregnant women.
Prevention of rubella
vaccination
How are enteroviaral infections transmitted
faecal oral route
Clinical features of enteroviral infections
Hand, foot and mouth disease- vascular rash like chickenpox but it fades away unlike crusting in chickenpox.
fever- rash
meningitis
runny nose and fever.
childhood respiratory infections include:
- Respiratory Syncytial Virus
- Para influenza
- Influenza
- Adenovirus
- Metapneumovirus
- Rhinovirus
What age group is bronchiolitis common in
0-24 months
How do you diagnose bronchiolitis
– PCR on secretions from nasopharyngeal aspirate
Tretament for bronchiolitis
O2, manage fever and fluid intake.
What type of virus is metapnemovirus
Paramyxovirus
How do you diagnose metapnemovirus
PCR rom the nasopharynx
Treatment for metapnemovirus
supporative only
What are the common symptoms from infection by adenovirus
– Conjunctivitis
– Diarrhoea
How do we diagnose adenovirus infection
respiratory panel PCR.
Eye swab PCR
Serology possible
How many types of parainfluenza are their and what seasons are they present in
4 types 1-4
1 in winter
3 in summer
How is parainfluenza transmitted
from person to person
Treatment for parainfluenza
none
How to diagnose parainfluenza
Multiplexed PCR
What does rhiovirus most commonly cause
common cold
Which 2 pathogens are mostly likely to be present in children with diahorhea
Rotavirus
Norovirus
How is rotovirus transmitted
faecal oral route and sometimes respiratory
How long is the incubation time of rotovirus
1-2 days.
What are the clinical features of rotovirus
- Diarrhoea and vomiting
- 6/12 – 2 yrs
- Severe disease c. 6/12
- Increased mortality in poorer countries
- Seasonal variation
How do we diagnose rotovirus
PCR
What is the treatment for rotovirus
rehydration
What prevention methods are used in rotovirus
vaccine
How is norovirus contracted
Foodborne
How is norovirus transmitted
Person to person spread
How is norovirus diagnosed
PCR
How is nor virus treated
Rehyradtion
What type of virus is Mumps
paramyxoyridae
How are mumps transmitted
– direct contact
– droplet spread
– fomites
How long in incubation from mumps
2-4 weeks (mostly 16-18 days)
How long is infectivity from mumps
several days before parotid swelling (cheeks swell) to several days after.
How do we prevent mumps
vaccination
Clinical symptoms of mumps
Prodrome – nonspecific e.g. low-grade fever, anorexia, malaise, and headache
Next 24 hours – earache, tenderness over ipsilateral parotid
Next 2-3 days – gradually enlarging parotid with severe pain
Normally bilateral but can be unilateral in at least 25%.
Pyrexia up to 40°C.- lower fevers are bacterial.
After peak swelling, pain, fever and tenderness rapidly resolve, and the parotid gland returns to normal size within 1 week.
Most common symptom of mumps
swelling of the parotid
Rare clinical manifestations of mumps.
– Epididymo-orchitis – Oophoritis – Meningitis – Encephalitis – Renal function abnormalities (mild) – Pancreatitis
Diagnosis of mumps
serology and PCR
Examples of neonatal viruses
VZV Rubella CMV Toxoplasma HSV HBV – HBIG/vaccine for neonatal. HIV – see BHIVA guidelines etc.
clinical features of CMV
growth retardation, deafness, blindness- Nonspecific symptoms without a rash.
ClinIcal features of toxoplamosis
chorioretinitis, hydrocephaly
Clinical features of HSV
congenital or perinatal. Severe neonatal disease – can cause encephalitis
