Childhood Viral Infections Flashcards
Name 6 notifiable diseases
Acute meningitis Acute poliomyelitis Measles Mumps Rubella Smallpox
What antibodies are in breast milk?
IgG
IgA
Virus that causes measules
Paramyxovirus- enveloped single stranded RNA virus
Describe the transmission for measles
Person-person. Droplet spread
Infectivity of measles and incubation period
4 days before rash to 4 days after disappearance (10-12 days incubation)
Natural hosts for measles
Only humans
Clinical features of measles
Rash, fever, conjunctivitis, coryza and cough
Koplick spots 1-2 days before rash.
Complications of measles
Otitis media Pneumonia Diarrhoea Acute encephalitis Subacute sclerosing panencephalitis (SSPE)
Describe the features of subacute sclerosing panencephalitis (SSPE)
Rare, fatal, late (7-30 yrs after measles) infection in pregnancy- 20% foetal loss
Treatment for measles
Supportive
Antibiotics for superinfection
Prevention of measles
MMR-1yr
Describe the causative organism for chicken pox
Varicella Zoster Virus-herpes virus- DNA virus
How is VZV transmitted?
Respiratory spread/personal contact
Incubation period for VZV
14-15 days
Infectivity of VZV
2 days before onset of rash until vesicles dry up.
Describe the rash in VZV
Centripetal (starts on trunk and diffuses peripherally)
Macular?papular>vesicuar>papular
Complications of VZV
Pneumonitis (increased risk for smokers)
CNS involvement
Thrombocytopenic purpura
Shingle (zoster)
Treatment for VZV
Aciclovir
Chlorpheniramine can relieve itch (>1yr)
Prevention for VZV
Live vaccine- 2 doses (not routine)
VZ immunoglobulins given in high risk cases
Where is Rubella a problem?
Poland
Causative organism for rubella
Togavirus, RNA virus
Transmission for rubella
Droplet spread
Incubation period for rubella
14-21 days
Infectivity of rubella
1 wk before rash to 4 days after
Clinical features of rubella
50% infectious children are asymptomatic. Non specific prodrome. Lymphadenopathy. V. non specific rash-behind ears, face and neck
Complications of rubella
Thrombocytopenia. Post infectious encephalitis, arthritis
Complications of rubella in pregnancy
‘congenital rubella syndrome’- more severe when contracted early in pregnancy.
Cateracts and other eye defects
Deafness
Cardiac abnormalities
Microcephaly
Retardation of intra-uterine growth
Inflammatory lesions of brain, liver, lungs and bone marrow
When in pregnancy is there a high risk of transmission of rubell?
less than 11 wks- 90% rish of transmission
Over 20 wks, no increased risk
Diagnosis of rubella
Serology IgG +ve for 3 months
Treatment for rubella
No treatment. Ig given to exposed pregnant women. Vaccine= MMR
Slapped cheek
Parovirus B19
Virus for parovirus B19
B19-DNA virus
Transmission of parovirus B19
Respiatory secretions or from mother to child
Incubation/infectivity for parovirus
Incubation- 4-14 dyas
Not infecctious once rash has developed
Foetal disease-parovirus B19
Anaemia, hydrops- foetal transfusion
Clinical features of parovirus B19
Minor respiratory illness Rash illness 'slapped cheek' Arthralgia Aplastic anaemia Anaemia in immunosuppressed
Treatment for parovirus B19
None if self-limiting illness. Blood transfusion. No vaccine available. Infectious prior to rash so infection control difficult
Causative organsisms for enteroviral infection
Cocksackie, entero, echoviral infections
Transmission of enteroviral infection
Faecal-oral and by skin contact. Hand, foot and mouth disease.
Clinical presentation of enteroviral infection
Fever-rash symptoms, can develop into meningitis
Treatment/prevention for enteriviral infections
Supportive management and good hygeine to prevent transmission
Causative organisms of respiratory synctial virus
Pneumovirus
Clinical manifestation of RSV
Bronchiolitis in under 1yrs.
Incubation period for RSV
4-6 days
Complications of RSV
Can be life threatening. Reinfections common
Causative organism of metapneumovirus
Paramyxovirus
Clinical manifestation of metapneumovirus
similar to RSV- from mild URTI to pneumonia. Nearly universal by 5yrs.
Adenovirus accounts for what proportion of childhood respiratory infections?
10%
Clinical manifestation of adenovirus
Mild uRTI
Conjunctivitis
Diarrhoea
Treatment for adenovirus in immunocompromised
Cidofovir
Causative organisms for parainfluenza
Paramyxovirus
How many types of parainfluenza are there?
4- 1 in winter, 3 in summer
Transmission of parainfluenza
Person-person, inhalation
Clinical manifestation of parainfluenza
Croup/bronchiolitis/URTI
The common cold- 70% children with mild URTI
Rhinovirus
3 infectious childhood diseases that result in diarrhoea
Rotavirus
Noravirus
Causative organism for rotavirus
Reovirus (RNA virus)
Transmission for rotavirus
Faecal-oral, occasionally respiratory
Incubation period for rotavirus
1-2 days
Prevention for rotavirus
Oral live vaccine
Causative organism for mumps
Paramyxoviridae family
Transmission of mumps
Direct contact, droplet spread
Infectivity of mumps
Several days before parotid swelling to several days after
Incubation period for mumps
2-4 weeks
CLinical manifestation of mumps
Non specific prodrome-fever, malaise, anorexia, headache. Next 24 hours-earache, tenderness over ipsilateral partid. Next 2-3 days, enlarging parotid, severe pain. Normally bilateral. Pyrexia
Complications of mumps
Meningitis, encephalitis, renal function abnormalities, pancreatitis, apididymo-orchitis-inflammation of epididymis. Infection in 1st trimester increases the risk of foetal death.
Diagnsosis of mums
Normal WCC. Raised serum amylase. Serology (IgM)
Treatment for MMR
MMR vaccine
