CP 6 - Childhood Virus

Question 1

what are some of the conditions seen in children which requires reporting to public health England

Answer 1

acute meingitis, acute poliomyelitis, measles, mumps, rubella, smallpox

Question 2

what immunoglobulin antibody is present in breast milk?

Answer 2

IgA

Question 3

which virus cause measles?

Answer 3

paramyxovirus

Question 4

how is paramyxovirus transmitted?

Answer 4

person to person - droplet spread

Question 5

how long is the incubation period for measles

Answer 5

7-18 days

Question 6

what are some clinical symptoms of measles

Answer 6

fever, malaise, conjunctivitis, coryza and cough (3Cs), rash - head to trunk

(Koplik’s spots) then rash + fever + 3Cs cough/coryza/conjunctivits

Question 7

what does prodrome mean ?

Answer 7

early symptoms

Question 8

what is conjunctivitis

Answer 8

injection of the conjunctiva

Question 9

what is coryza

Answer 9

irritation and inflammation of the mucous membrane inside the nose

Question 10

what is a characteristic for measles which appear before rash

Answer 10

Koplik’s spots - manifest 2-3 days before the appearance of rash

Question 11

what are some of the complication of measles

Answer 11

otitis media (medial ear infection - can lead to hearing loss), pneumonia, diarrhoea, rare - acute encephalitis, v. rare - subacute sclerosing panencephalitis (v. deadly)

Question 12

how is measles diagnosed

Answer 12

clinical presentation, leukopenia (reduction in WBC), oral fluid sample, serology

Question 13

what are treatment for measles

Answer 13

virus - symptoms relief and antibiotic for superficial infection.

Question 14

what is the prevention of measles

Answer 14

MMR vaccine

Question 15

which virus cause chicken pox

Answer 15

varicella zoster virus

Question 16

how is varicella zoster virus transmitted

Answer 16

respiratory spread/personal contact

Question 17

what is the incubation period of the varicella zoster virus

Answer 17

14-15 days

Question 18

when will the varicella zoster virus be in infective stage

Answer 18

2 days before onset of rash until after vesicles dry up

Question 19

what are some of the clinical features of VZV

Answer 19

fever, malaise, anorexia, rash - centripetal (concentrated in the middle of the body) & vesicular

Question 20

what are some of the complication for VZV

Answer 20

pneumonitis, CNS involvement (shingles), thrombocytopenic purpura (easy or excessive bleeding) , foetal varicella snydrome, zoster

Question 21

who is at greater risk of more severe complication of varicella zoster viruses

Answer 21

smoker and those who take long term steroids

Question 22

what are the diagnosis for varicella zoster virus

Answer 22

clinical presentation, PCR - vesicle fluid/CSF, serology (IgG in pregnant women)

Question 23

treatment for varicella zoster virus

Answer 23

for symptomatic adults and immunocompromised children - aciclovir

Question 24

how can varicella zoster virus be prevented?

Answer 24

live vaccine, 2 doses & varicella zoster virus immunoglobulin (maybe to immunosuppressed patients, neonates and pregnant woman)

Question 25

which virus cause rubella

Answer 25

togavirus (RNA virus)

Question 26

how is togavirus transmitted?

Answer 26

droplet spread - air bourne

Question 27

incubation period for togavirus

Answer 27

14-21 days

Question 28

when will togavirus be infective?

Answer 28

one week before rash to 4 days after

Question 29

what are some of the clinical presentation for rubella

Answer 29

lymphadenopathy (abnormal lymph node), suboccipital, post-auricular (behind eyes), rash (very non-specific, transient, behind ears and face and neck)

Question 30

what are some complication for rubella

Answer 30

thrombocytopenia (deficiency of platelet), post infectious encephalitis, arthritis

Question 31

will rubella always be symptomatic

Answer 31

no, about 50% of children are asymptomatic

Question 32

where will rashes of rubella start?

Answer 32

from face then spread to the rest of the body

Question 33

what is congenital rubella syndrome

Answer 33

rubella in pregnancy

Question 34

what can congenital rubella syndrome cause to the baby?

Answer 34

``` cataracts and eye defects deafness microcephaly cardiac abnormalities retardation of intra-uterine growth inflammatory lesions of brain, liver, lungs and bone marrow ```

Question 35

when is the most dangerous period for pregnant woman to contract rubella resulting in congenital rubella syndrome

Answer 35

the more early the infection is the more dangerous it is

Question 36

how can rubella be diagnosed

Answer 36

oral fluid testing - IgM/G serology - IgM/G antibodies detectable from time of rash, IgM +ve for 1-3 months

Question 37

what are treatment for rubella

Answer 37

no treatment available - Ig given to exposed pregnant women

Question 38

what is erythema infectiosum caused by

Answer 38

parvovirus B19

Question 39

how is parvovirus B19 transmitted?

Answer 39

by respiratory secretions or from mother to child

Question 40

what can parvovirus cause in pregnant ladies?

Answer 40

v.low risk of miscarriage in early pregnancy can cause foetal disease - anaemia, hydrops which requires transfusion.

Question 41

what is infection of parvovirus B19 common known as

Answer 41

slipped cheek disease

Question 42

what are some of the clinical presentation for parvovirus B19

Answer 42

minor respiratory illness, rash illness 'slapped cheeck', arthralgia (painful joint), aplastic anaemia (also in immunosuppressed)

Question 43

what are the diagnosis for parvovirus B19

Answer 43

serology IgM/IgG, amniotic fluid sampling,

Question 44

treatment for slapped cheek disease?

Answer 44

none if self-limiting, blood transfusion

Question 45

when is parvovirus infective?

Answer 45

before rash appear (makes diagnosis and prevent difficult as once rash appears then no longer infective)

Question 46

what can cause hand, foot and mouth disease

Answer 46

enteroviral, echociral, coxsackie

Question 47

what can cause respiratory syncytial virus

Answer 47

Pneumovirus

Question 48

clinical presentation for respiratory syncytial virus

Answer 48

bronchiolitis

Question 49

diagnosis for respiratory syncytial virus

Answer 49

PCR on secretion from nasopharyngeal aspirate

Question 50

treatment for respiratory syncytial virus

Answer 50

O2 really usaully self-limiting

Question 51

what other virus can cause similar respiratory illness similar to RSV

Answer 51

Metapneumovirus

Question 52

diagnosis for metapneuovirus

Answer 52

PCR

Question 53

what does adenovirus cause?

Answer 53

respsonsible for 10% of childhood respiratory infection

Question 54

clinical presentation of adenovirus?

Answer 54

conjunctivitis & URTI

Question 55

diagnosis for adenovirus

Answer 55

respiratory panel PCR, eye swab PCR

Question 56

how is parainfluenza transmitted?

Answer 56

person to person - inhalational croup/broncholitis/URTI

Question 57

what does rhinovirus cause?

Answer 57

common cold

Question 58

what are the 2 types of viruses which can cause diarrhoea

Answer 58

rotavirus, norovirus

Question 59

how is rotavirus transmitted

Answer 59

faecal-oral

Question 60

clinical presentation of rotavirus

Answer 60

diarrhoea and vomiting

Question 61

diagnosis and treatment for rotavirus

Answer 61

PCR & rehydration

Question 62

how can rotavirus be prevented

Answer 62

oral live vaccine

Question 63

what is another name for norovirus

Answer 63

winter vomiting bug

Question 64

how can norovirus be transmitted

Answer 64

person to person spread

Question 65

diagnosis and treatment for norovirus

Answer 65

PCR and rehydration

Question 66

what can cause Mumps

Answer 66

paramyxoviridae family

Question 67

how can paramyxovirida family ie mumps be transmitted?

Answer 67

direct contact, droplet spread

Question 68

when is paramyxovirida family infective

Answer 68

several days before and after

Question 69

clinical features for mumps

Answer 69

initial - non-specific - low-grade fever, anorexia, malaise and headache next 24 hours - earache, tenderness over ipsilateral parotid next 2-3 days - gradual swelling of parotid with sever pain pyrexia - up to 40 degree

Question 70

what are some of the rarer complication for mumps

Answer 70

``` Submandibular and/or sublingual sialadenitis Epididymo-orchitis Oophoritis Meningitis Encephalitis Renal function abnormalities (mild) Pancreatitis ```

Question 71

what is the most common clinical presentation of mumps in adult

Answer 71

Epididymo-orchitis

Question 72

diagnosis of mumps

Answer 72

Serology (IgM) Blood Saliva (PCR)