Core Microbiology - Childhood Viral Infections (6) Flashcards

1
Q

Notifiable diseases

A
  • Acute meningitis
  • Acute poliomyelitis
  • Measles
  • Mumps
  • Rubella
  • Smallpox
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2
Q

Notifiable diseases

A
  • Acute meningitis
  • Acute poliomyelitis
  • Measles
  • Mumps
  • Rubella
  • Smallpox
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3
Q

IgM produced

A

In acute infection

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4
Q

IgG produced

A

In long term immunity

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5
Q

IgA produced

A

In breast milk - maternal antibody

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6
Q

Child with a rash

A

Parvovirus, measles, Chickenpox, Rubella, Non-polio enterovirus infection, EBV (ampicillin), Staph. aureus, N. meningitidis

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7
Q

What virus causes measles?

A

Paramyxovirus (enveloped single stranded RNA virus)

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8
Q

Measles transmission

A

Person to person, droplet spread

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9
Q

Measles infectivity

A

From start of first symptoms - 4 days before rash > 4 days after rash

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10
Q

Measles incubation

A

7-18 days (average 10-12)

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11
Q

Measles natural host

A

Only humans

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12
Q

Clinical features of measles - 3 C’s

A

Conjunctivits, coryza (rhinitis) and cough

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13
Q

Clinical features of measles

A

Fever, malaise, conjunctivitis, coryza, cough, rash (eryhematous, macuopapular, head and trunk), Koplik’s spots (1-2 days before rash - mouth)

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14
Q

Complications of measles

A

Otitis media, pneumonia, diarrhoea, acute encephalitis

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15
Q

Rare complications of measles

A

Subacute sclerosing panencephalitis (SSPE) - brain disorder - fatal

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16
Q

Death in measles

A

Highest in

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17
Q

Diagnosis of measles

A

Clinical, leukopenia, oral fluid sample, serology

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18
Q

Prevention of measles

A

Live MMR vaccine - 1 year/pre-school, human normal, Ig

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19
Q

Chicken pox virus

A

Varicella Zoster virus/Herpes virus (DNA)

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20
Q

Transmission of chicken pox

A

Respiratory spread/personal contact (15 mins)

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21
Q

Incubation period of chicken pox

A

14-15 days

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22
Q

Infectivity of chicken pox

A

2 days before onset of rash until after vesicles dry up

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23
Q

Clinical features of chicken pox

A

Fever, malaise, anorexia, rash

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24
Q

Chicken pox rash

A

Centripetal (trunk and face)

Macular > papular > vesicular > pustular

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25
Q

Complications of chicken pox

A

Pneumonitis (risk increased for smoker), CNS involvement, thrombocytopenic purpura, foetal varicella syndrome, congenital varicella, zoster

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26
Q

Diagnosis of chicken pox

A

Clinical/PCR - vesicle fluid/CSF

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27
Q

Serology of chicken pox

A

Immunity, IgG in pregnant women

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28
Q

Treatment of chicken pox

A

Aciclovir and cholrpheiramine (relieve itch)

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29
Q

Who gets treatment for chicken pox?

A

Symptomatic adults and immunocompromised children

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30
Q

Prevention of chicken pox

A

Live vaccine (USA/Japan), VZ immunoglobulin (VZIG)

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31
Q

Rubella (the third disease) virus

A

Togavirus, RNA virus

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32
Q

Rubella Transmission

A

Droplet spread (air-bourne), less contagious

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33
Q

Incubation period Rubella

A

14-21 days

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34
Q

Clinical features of Rubella

A

Lymphadenopathy (post-auricular, suboccipital), rash, fever, tiredness, aching joints (50% asymptomatic)

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35
Q

Rubella rash

A

Non-specific, erythematous, behind ears and face and neck

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36
Q

Complications of Rubella

A

Thrombocytopenia, post infectious encephalitis, arthritis

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37
Q

Rubella in pregnancy/Congenital Rubella syndrome (CRS)

A

Cataracts, deafness, cardiac abnormalities, microcephaly, retardation of intra-uterine growth, inflammatory lesions of brain, liver, lungs and bone marrow

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38
Q

Diagnosis of Rubella

A

Oral fluid testing/serology (IgM/G)

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39
Q

Prevention

A
  • Ig given to pregnant exposed women

- Vaccine (MMR)

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40
Q

Erythema infectiosum/slapped cheek/fifth disease virus

A

Parvovirus B19 (DNA)

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41
Q

Transmission of Erythema infectiosum

A

Respiratory secretions, mother > child

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42
Q

Erythema infectiosum incubation period

A

4-14 days

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43
Q

Erythema infectiosum clinical

A

Minor respiratory, rash (slapped cheek), arthralgia, aplastic anaemia (20% asymptomatic)

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44
Q

Erythema infectiosum foetal presentation

A

Anaemia and hydrops (accumulation of fluid)

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45
Q

Diagnosis of Parvovirus

A

Serology IgM/G, amniotic fluid sampling, PCR (immunocompromised)

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46
Q

Treatment of Erythema infectiosum

A

None/blood transfusion

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47
Q

Enteroviral infections

A

Coxsackie, entero, echoviral infections

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48
Q

Prevalence of enteroviral infections

A

In under 5s

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49
Q

Enteroviral infections transmission

A

Faecal-oral and skin contact

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50
Q

Enteroviral infections clinical presentation

A

90% asymptomatic, hand, foot and mouth rash, meningitis

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51
Q

Child with respiratory symptoms

A
  • Respiratory Syncytial Virus
  • Parainfluenza
  • Influenza
  • Adenovirus
  • Metapneumovirus
  • Rhinovirus
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52
Q

RSV virus

A

Pneumovirus

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53
Q

RSV bronchiolitis

A
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54
Q

RSV diagnosis

A

PCR - secretions from nasopharyngeal aspirate

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55
Q

RSV treatment

A

O2, manage fever and fluid intake, Palivizumab - Ig/monoclonal abs

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56
Q

Metapneumovirus virus

A

Paramyoxvirus

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57
Q

Metapneumovirus age

A

5 yrs

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58
Q

Metapneumovirus clinical

A

Similar RSV, mild upper respiratory tract infection > pnuemonia

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59
Q

Metapneumovirus diagnosis

A

PCR

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60
Q

Adenovirus incidence

A

10% childhood respiratory infection

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61
Q

Adenovirus clinical presentation

A

Mild URTI, conjunctivitis, diarrhoea

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62
Q

Adenovirus diagnosis

A

PCR (eye swab/resp), serology

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63
Q

Adenovirus treatment

A

Cidofovir for immunocomproised

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64
Q

Parainfluenza virus

A

Paramyxovirus (4 types)

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65
Q

Parainfluenza transmission

A

Person to person - inhalation

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66
Q

Parainfluenza clinical presentation

A

Croup, bronchiolitis, URTI

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67
Q

Parainfluenza diagnosis

A

Multiplexed PCR

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68
Q

Common cold

A

Rhinovirus

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69
Q

Child with diarrhoea

A

Rotavirus or Norovirus

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70
Q

Rotavirus virus

A

Reovirus (RNA)

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71
Q

Rotavirus tranmission

A

Facecal-oral (respiratory), low infective dose

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72
Q

Rotavirus incubation period

A

1-2 days

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73
Q

Rotavirus epidemiology

A

Seasonal UK (winter/spring), worldwide, 440,000 deaths/yr

74
Q

Rotavirus clincial presentation

A

Diarrhoea, vomiting (6 months - 2 years)

75
Q

Rotavirus diagnosis

A

PCR

76
Q

Rotavirus treatment

A

Rehydration

77
Q

Rotavirus prevention

A

Oral live vaccine - 2 and 3 months

78
Q

Winter vomiting bug

A

Norovirus

79
Q

Norovirus transmission

A

Foodborne, person to person spread

80
Q

Norovirus diagnosis

A

PCR

81
Q

Norovirus treatment

A

Rehydration

82
Q

Mumps virus

A

Paramyxoviridae family

83
Q

Mumps tranmission

A

Direct contact, droplet spread, fomites

84
Q

Mumps infectivity

A

Several days before partoid swelling > several days after

85
Q

Mumps incubation

A

2-4 weeks (mostly 16-18 days)

86
Q

Mumps clinical presentation

A

Low-grade fever, anorexia, malaise, headache, pyrexia

87
Q

Mumps clinical presentation next 24 hours

A

Earache, tenderness over ipsilateral parotid

88
Q

Mumps clinical presentation next 2-3 days

A

Gradually enlarging parotid with severe pain

89
Q

Mumps rare clinical presentation

A

Submandibular/lingual sialadenitis, epidiymo-orchitis, oophoritis, meningitis, encephalitis, renal function abnormalities (mild), pancreatitis

90
Q

Mumps diagnosis

A

Raised serum amylase, normally clincal, serology (blood/saliva), PCR

91
Q

Neonatal/congenital infection

A
  • VZV
  • Rubella
  • CMV (growth retardation, deafness, blindess)
  • Toxoplasma (chorioretintis, hydrocephaly)
  • HSV (congenital/perinatal - severe neonatal disease)
  • HBV
  • HIV
92
Q

IgM produced

A

In acute infection

93
Q

IgG produced

A

In long term immunity

94
Q

IgA produced

A

In breast milk - maternal antibody

95
Q

Child with a rash

A

Parvovirus, measles, Chickenpox, Rubella, Non-polio enterovirus infection, EBV (ampicillin), Staph. aureus, N. meningitidis

96
Q

What virus causes measles?

A

Paramyxovirus (enveloped single stranded RNA virus)

97
Q

Measles transmission

A

Person to person, droplet spread

98
Q

Measles infectivity

A

From start of first symptoms - 4 days before rash > 4 days after rash

99
Q

Measles incubation

A

7-18 days (average 10-12)

100
Q

Measles natural host

A

Only humans

101
Q

Clinical features of measles - 3 C’s

A

Conjunctivits, coryza (rhinitis) and cough

102
Q

Clinical features of measles

A

Fever, malaise, conjunctivitis, coryza, cough, rash (eryhematous, macuopapular, head and trunk), Koplik’s spots (1-2 days before rash - mouth)

103
Q

Complications of measles

A

Otitis media, pneumonia, diarrhoea, acute encephalitis

104
Q

Rare complications of measles

A

Subacute sclerosing panencephalitis (SSPE) - brain disorder - fatal

105
Q

Death in measles

A

Highest in

106
Q

Diagnosis of measles

A

Clinical, leukopenia, oral fluid sample, serology

107
Q

Prevention of measles

A

Live MMR vaccine - 1 year/pre-school, human normal, Ig

108
Q

Chicken pox virus

A

Varicella Zoster virus/Herpes virus (DNA)

109
Q

Transmission of chicken pox

A

Respiratory spread/personal contact (15 mins)

110
Q

Incubation period of chicken pox

A

14-15 days

111
Q

Infectivity of chicken pox

A

2 days before onset of rash until after vesicles dry up

112
Q

Clinical features of chicken pox

A

Fever, malaise, anorexia, rash

113
Q

Chicken pox rash

A

Centripetal (trunk and face)

Macular > papular > vesicular > pustular

114
Q

Complications of chicken pox

A

Pneumonitis (risk increased for smoker), CNS involvement, thrombocytopenic purpura, foetal varicella syndrome, congenital varicella, zoster

115
Q

Diagnosis of chicken pox

A

Clinical/PCR - vesicle fluid/CSF

116
Q

Serology of chicken pox

A

Immunity, IgG in pregnant women

117
Q

Treatment of chicken pox

A

Aciclovir and cholrpheiramine (relieve itch)

118
Q

Who gets treatment for chicken pox?

A

Symptomatic adults and immunocompromised children

119
Q

Prevention of chicken pox

A

Live vaccine (USA/Japan), VZ immunoglobulin (VZIG)

120
Q

Rubella (the third disease) virus

A

Togavirus, RNA virus

121
Q

Rubella Transmission

A

Droplet spread (air-bourne), less contagious

122
Q

Incubation period Rubella

A

14-21 days

123
Q

Clinical features of Rubella

A

Lymphadenopathy (post-auricular, suboccipital), rash, fever, tiredness, aching joints (50% asymptomatic)

124
Q

Rubella rash

A

Non-specific, erythematous, behind ears and face and neck

125
Q

Complications of Rubella

A

Thrombocytopenia, post infectious encephalitis, arthritis

126
Q

Rubella in pregnancy/Congenital Rubella syndrome (CRS)

A

Cataracts, deafness, cardiac abnormalities, microcephaly, retardation of intra-uterine growth, inflammatory lesions of brain, liver, lungs and bone marrow

127
Q

Diagnosis of Rubella

A

Oral fluid testing/serology (IgM/G)

128
Q

Prevention

A
  • Ig given to pregnant exposed women

- Vaccine (MMR)

129
Q

Erythema infectiosum/slapped cheek/fifth disease virus

A

Parvovirus B19 (DNA)

130
Q

Transmission of Erythema infectiosum

A

Respiratory secretions, mother > child

131
Q

Erythema infectiosum incubation period

A

4-14 days

132
Q

Erythema infectiosum clinical

A

Minor respiratory, rash (slapped cheek), arthralgia, aplastic anaemia (20% asymptomatic)

133
Q

Erythema infectiosum foetal presentation

A

Anaemia and hydrops (accumulation of fluid)

134
Q

Diagnosis of Parvovirus

A

Serology IgM/G, amniotic fluid sampling, PCR (immunocompromised)

135
Q

Treatment of Erythema infectiosum

A

None/blood transfusion

136
Q

Enteroviral infections

A

Coxsackie, entero, echoviral infections

137
Q

Prevalence of enteroviral infections

A

In under 5s

138
Q

Enteroviral infections transmission

A

Faecal-oral and skin contact

139
Q

Enteroviral infections clinical presentation

A

90% asymptomatic, hand, foot and mouth rash, meningitis

140
Q

Child with respiratory symptoms

A
  • Respiratory Syncytial Virus
  • Parainfluenza
  • Influenza
  • Adenovirus
  • Metapneumovirus
  • Rhinovirus
141
Q

RSV virus

A

Pneumovirus

142
Q

RSV bronchiolitis

A

Below 1, annual winter epidemic, 4-6 days incubation

143
Q

RSV diagnosis

A

PCR - secretions from nasopharyngeal aspirate

144
Q

RSV treatment

A

O2, manage fever and fluid intake, Palivizumab - Ig/monoclonal abs

145
Q

Metapneumovirus virus

A

Paramyoxvirus

146
Q

Metapneumovirus age

A

5 yrs

147
Q

Metapneumovirus clinical

A

Similar RSV, mild upper respiratory tract infection > pnuemonia

148
Q

Metapneumovirus diagnosis

A

PCR

149
Q

Adenovirus incidence

A

10% childhood respiratory infection

150
Q

Adenovirus clinical presentation

A

Mild URTI, conjunctivitis, diarrhoea

151
Q

Adenovirus diagnosis

A

PCR (eye swab/resp), serology

152
Q

Adenovirus treatment

A

Cidofovir for immunocomproised

153
Q

Parainfluenza virus

A

Paramyxovirus (4 types)

154
Q

Parainfluenza transmission

A

Person to person - inhalation

155
Q

Parainfluenza clinical presentation

A

Croup, bronchiolitis, URTI

156
Q

Parainfluenza diagnosis

A

Multiplexed PCR

157
Q

Common cold

A

Rhinovirus

158
Q

Child with diarrhoea

A

Rotavirus or Norovirus

159
Q

Rotavirus virus

A

Reovirus (RNA)

160
Q

Rotavirus tranmission

A

Facecal-oral (respiratory), low infective dose

161
Q

Rotavirus incubation period

A

1-2 days

162
Q

Rotavirus epidemiology

A

Seasonal UK (winter/spring), worldwide, 440,000 deaths/yr

163
Q

Rotavirus clincial presentation

A

Diarrhoea, vomiting (6 months - 2 years)

164
Q

Rotavirus diagnosis

A

PCR

165
Q

Rotavirus treatment

A

Rehydration

166
Q

Rotavirus prevention

A

Oral live vaccine - 2 and 3 months

167
Q

Winter vomiting bug

A

Norovirus

168
Q

Norovirus transmission

A

Foodborne, person to person spread

169
Q

Norovirus diagnosis

A

PCR

170
Q

Norovirus treatment

A

Rehydration

171
Q

Mumps virus

A

Paramyxoviridae family

172
Q

Mumps tranmission

A

Direct contact, droplet spread, fomites

173
Q

Mumps infectivity

A

Several days before partoid swelling > several days after

174
Q

Mumps incubation

A

2-4 weeks (mostly 16-18 days)

175
Q

Mumps clinical presentation

A

Low-grade fever, anorexia, malaise, headache, pyrexia

176
Q

Mumps clinical presentation next 24 hours

A

Earache, tenderness over ipsilateral parotid

177
Q

Mumps clinical presentation next 2-3 days

A

Gradually enlarging parotid with severe pain

178
Q

Mumps rare clinical presentation

A

Submandibular/lingual sialadenitis, epidiymo-orchitis, oophoritis, meningitis, encephalitis, renal function abnormalities (mild), pancreatitis

179
Q

Mumps diagnosis

A

Raised serum amylase, normally clincal, serology (blood/saliva), PCR

180
Q

Neonatal/congenital infection

A
  • VZV
  • Rubella
  • CMV (growth retardation, deafness, blindess)
  • Toxoplasma (chorioretintis, hydrocephaly)
  • HSV (congenital/perinatal - severe neonatal disease)
  • HBV
  • HIV