Childhood Viral Infections Flashcards
What immunoglobulin is found in acute infection?
IgM
Where does a child acquire IgG?
From mother.
Where is IgA acquired from?
Breast milk.
What Ig presence indicates previous infection and why?
IgG- because it is for long term immunity.
What type of virus is Measles?
Enveloped single stranded RNA.
How is Measles transmitted?
Person to person - droplet.
When is Measles infective?
4 days before rash to 4 days after rash.
“ 4 by 4”
What are the characteristics of a measles rash?
> Head-trunk
Maculo-papular
Erythmatous
What disease are Koplik’s spots found in?
Measles
What 3C’s are assc with Measles?
Cough, Coryza (Rhinitis), Conjunctivitis.
What is Otitis Media?
Middle Ear infection –> ~ hearing loss.
What are the complications of Measles?
- Otitis Media
- Pneumonia
- Diarrhoea
- Acute Encephalitis
What are the rarer complications of Measles?
- Subacute sclerosing panencephalitis (SSPE)
- Infection in pregnancy
What is the incidence of Subacute sclerosing panencephalitis (SSPE)?
1/25000
Leukopenia confirms the diagnosis of what virus?
Measles
What does the MMR vaccine prevent?
Measles, Mumps and Rubella.
What is Chicken Pox also known as?
Varicella Zoster
What type of virus is Varicella Zoster?
A Herpes virus.
How is Varicella Zoster spread?
Resp spread/ human contact.
What is the Measles incubation period?
10-12 days
What is the Varicella Zoster incubation period?
~2 weeks (“Went to India for 2 weeks and got it”)
When is Varicella Zoster infective?
2 days before the rash to after vesicles dry up.
Where can chicken pox remain dormant?
Dorsal Root Ganglion
What can chicken pox resurface as?
Shingles in a single dermatome - painful
Is a Chicken pox rash more pustular or macular?
Macular > pustular
Fever, Malaise and Anorexia belong to which virus?
Varicella Zoster
Complications of Varicella Zoster include:
> Pneumonitis (incr for smokers)
CNS involvement
Thrombocytopenic purpura
Congenital/Foetal varicella zoster.
Who should be treated for Varicella Zoster?
Symptomatic adults
Immunocompromised children
What does Aciclovir treat?
Varicella Zoster
What does Chlorpheniramine do?
Relieves itching in Chicken pox.
How can Varicella Zoster be prevented?
With a live vaccine.
When is Varicella Zoster Ig given?
> If condition predisposes to severe varicella –> immunosuppressed, pregnant women
If no antib’s to VZ virus
Does VZ Ig prevent VZ?
No, reduces severity.
What type of virus is Rubella?
Hint : R to R
RNA Virus
What virus causes Rubella?
Togavirus
How is Rubella transmitted?
Droplet infection- air bourne
What is Rubella’s incubation period?
14-21 days
When is Rubella infective?
One week before rash to 4 days after
What are the clinical features of Rubella?
> Lymphadenopathy - post-auricular, suboccipital.
Rash - non specific
Many = asymptomatic
Young females ~ aching joints.
What are the complications of Rubella?
Thrombocytopenia, post infectious encephalitis, arthritis.
What are the clinical features of congenital rubella syndrome?
> Inflammed lesion of brain, liver, bone and lung.
Cataracts
Deafness
Retarded inter-uterine growth
When is foetal damage rare after?
Week 16
When is deafness in CRS reported up until?
Week 20
What type of virus is Parvovirus B19?
A DNA virus
How is Parvovirus B19 spread?
Resp secretions or mother –> child.
What is Parvovirus B19’s incubation period?
4-14 days.
What is hydrops and what virus causes it?
Abnormal fluid buildup in foetus caused by Parvovirus B19.
What rash characterises Parvovirus B19? (Hint: Think Pam)
“Slapped Cheek”
What are the clinical features of Parvovirus B19?
> Rash illness
Arthralgia - pain in a joint
Aplastic anaemia
How is Parvovirus diagnosed in foetuses?
Amniotic fluid sample - IgM
How is it diagnosed in immunocompromised?
PCR
Is Parvovirus self limiting or not?
Self-limiting. No vaccine (Can use blood transfusion)
In whom are Enteroviral infections most prevalent?
Under 5 year olds
How are Enteroviral infections transmitted?
Faecal-oral
What diseases can Enteroviruses cause?
> Hand, foot and mouth
Meningitis
Fever/Rashes
In whom is Broncholitis most common?
Under 1 year olds
What type of virus causes Broncholitis?
Respiratory Syncytial
How long does Broncholitis incubate for?
4-6 days
How are Resp Synctial viruses diagnosed?
PCR on secretions from nasopharyngeal aspirate
When is Palivizumab given and to who?
Neonates with Resp syncytial virus.
What are the symptoms of Metapneumovirus?
Hint : Weaker than Resp Syncytial
Runny nose, fever, sore throat.
What percentage of childhood RTI’s does Adenovirus account for?
10%
Conjunctivitis, Mild URTI and diarhoea are assc with what virus?
Adenovirus
What family does Rhinovirus come from?
Picronaviridae
What virus causes Rotavirus?
Reovirus
How is Rotavirus transmitted?
Faecal - oral
Hint: Think GI for clinical features and treatment
What are the clinical features of Rotavirus?
Vomiting and diarrhoea
How long does Rotavirus incubate?
1-2 days
Norovirus is a short course disease, how long?
12-60hrs
How is Norovirus transmitted?
Foodbourne
What virus family causes Mumps?
Paramyxoviridae
How is Mumps transmitted?
Direct/droplet/fomitea
How long is Mumps infective for?
Before parotid swelling to after.
How long does Mumps incubate for?
2/4 weeks
What are the clinical features of mumps?
> Swollen parotid (usually bilateral)
> Non-specific prodome - fever (40 degrees), headache.
What are the rarer clinical features of Mumps?
Hint: All inflammations
> Submandibular/lingual sialadentitis > Oophoritis > Epidydmo-orchitis > Encephalitis > Meningitis > Pancreatitis