Emerging Infections

Question 1

H5N1- animal hosts

Answer 1

Water fowl, sometimes pig

Question 2

How often does avian flu cross species boundaries to infect humans

Answer 2

rarely

Question 3

avian flu- genome

Answer 3

segmented genome

16H, 9N in various combinations

Question 4

avian flu- most pathogenic H

Answer 4

H5 or H7

Question 5

How do H5 and H7 become more pathogenic

Answer 5

water fowl cary them other poultry flocks where they mutate and recombine

Question 6

Avian flu implications for humans

Answer 6

Risk of it spreading poultry to human or mutating to become more infectious in humans.
People are more likely to become infected in the processing of poultry rather than consumption

Question 7

Avian flu- tx

Answer 7

Neurominidase inhibitors- but there is not enough

Question 8

Avian flu prevention

Answer 8

Hand hygine and reparatory etiquette but that may not be enough

Question 9

3 Requirements for a viral pandemic

Answer 9

Infect humans
Cause serious illness
Human to Human spread

Question 10

Does H5N1 meet the requirements to be a viral pandemic?

Answer 10

It can infect humans
It can cause serious illness
It cannot spread human to human yet- but mutations or a recombination with another flu type may spred the virus

Question 11

what does MRSA stand for

Answer 11

Methicillin Resistant Staph Aureus

Methicillin = oxacillin

Question 12

How many types of MRSA are there

Answer 12

Hospital acquired- been around forever

Community acquired- often confused with spider bites

Question 13

Dx CA- MRSA

Answer 13

Positive MRSA culture w/in 48 hours of hospital admission
No hx of MRSA infxn
No med hx n the last yaer of significant time in medical facilities including surgery and dialysis
no permanent medical devices that pass through skin. ie indwelling catheters

Question 14

Where did CA MRSA come from?

Answer 14

developed on its own, its not a new version of HA- MRSA

Question 15

CA- MRSA- who is the pt

Answer 15

young with no hx of MRSA infection that have extremely close contact with other people
Skin and soft tissue abcesses ie wound infection, pneumonia or bacteremia

Question 16

CA- MRSA resistance pattern compared to HA

Answer 16

much less extensive

Question 17

Panton Valentine Leucocidin

Answer 17

virulence factor found on some strains of CA- MRSA

Question 18

HA- MRSA who is this patient

Answer 18

Old or ill with line or wound infection or pneumonia

Question 19

Resistance pattern of HA- MRSA

Answer 19

Methicillin, fluroquinolones, clindamycin

Question 20

CA- MRSA-tx

Answer 20

Incise and Drain

Use antibiotics when needed

Question 21

CA- MRSA tx

Answer 21

very durable in the environment

has multiple fomites- hands, clothing, equipment

Question 22

CA- MRSA prevention

Answer 22

hand washing and personal cleanliness, keep your wounds covered and dont touch other peoples
dont share personal items liker razors or towels

Question 23

What type of virus is SARS

Answer 23

Coronovirus

Question 24

SARS transmission

Answer 24

Animal to human

Question 25

What type of diseaes does SARS cause

Answer 25

Respiratory illness

Question 26

Coronovirus causes 30% of what dieses

Answer 26

colds

Question 27

Are coronoviruses mostly upper or lower respiratory infections

Answer 27

upper

Question 28

Cornovirus replication

Answer 28

RNA dependent RNA polymerase

Question 29

SARS symptoms

Answer 29

fever, headache, body ache- flue like | 3-10 days most pts dev penumonia

Question 30

Does SARS have a high or low mortality rate for a virus

Answer 30

High

Question 31

What is the SARS containment stratetigy

Answer 31

Detect, Isolate, quarantine

Question 32

What are standard precautions to prevent the spread of SARS

Answer 32

hand washing, eye precaution

Question 33

What are contact precautions to prevent the spread of SARS

Answer 33

Gloves and Gown

Question 34

What are airborne precautions to prevent the spread of SARS

Answer 34

isolation room with negative pressure | filtering disposable respirator

Question 35

what is the public health definition of isolation. Where does it occur

Answer 35

restriction of movement of sick people with an infectious disease This can be at the hospital, home, or special facility

Question 36

What is the public health definition of quarantine, where does it occur, what are the levels

Answer 36

Isolating healthy people thought to have been exposed to a disease. This usually occurs at the home but can be in the hospital or dedicated facility This can be at the individual, community, or population level

Question 37

How is West Nile virus spread

Answer 37

Animal --> mosquito --> humans

Question 38

What is the dead end host for west hile virus

Answer 38

Humans

Question 39

Is West nile ever transfered human to human

Answer 39

rarely in blood transfusions or breast milk

Question 40

what are the symptoms of West nile viurs

Answer 40

people rarely get ill but 20% of people get flu like symptoms

Question 41

More severe sequellea of West Nile Disease

Answer 41

West nile encephalitis/ Meningitis | West nile poliomyelitis

Question 42

what are the symptoms of the more severe west nile virus

Answer 42

headache, fever, stiff neck, stupor, disorientation, coma, tremors, weakness, paralysis

Question 43

What age population is at the greatest risk for west nile virus

Answer 43

aged 50 yrs or older

Question 44

West nile virus diagnosis, how is made clinically and with labs

Answer 44

clinical symptoms + Hx | Anti west nile IgM

Question 45

West NIle virus treatment

Answer 45

None

Question 46

What is the main focus of prevention of west nile treatment

Answer 46

avoid misquito bites

Question 47

What types of things is cyclosporias associated with

Answer 47

tap water and poorly cleaned produce

Question 48

What organ system does Cyclosporia affect

Answer 48

GI

Question 49

what are the symptoms of Cyclosporia infection

Answer 49

``` Diarrhea Cramps Dehydration Bloating Constipation Nausea ```

Question 50

What is the treatment for Cyclosporias

Answer 50

Trimethoprim

Question 51

What are the complications of cyclosporias if they are left untreated

Answer 51

Reiter's syndrome | Guillain Barre syndrome

Question 52

What are the symptoms of Reithers syndrome, when does this occur

Answer 52

After several weeks of infection Ocular inflammation - conjucntivitis, iritis, episclaritis inflammatory oligoarthritis sterile urethritis

Question 53

How long does the diarrhea from cyclosporias last

Answer 53

6 weeks

Question 54

H1N1- is a combination of which types of flu viruses

Answer 54

Avian, Human, Swine, Eurasian Swine

Question 55

Who is most commonly infected with H1N1, why?

Answer 55

younger cohort. b/c they have never seen it before | 0-24

Question 56

What age range has the highest mortality for H1N1?

Answer 56

middle aged- 25-49

Question 57

Why is there a rise in Tb

Answer 57

Non compliance | Tx requires 3 drugs and mental status, socioeconomic status all contribute to Tb resistance

Question 58

How has AIDS changed Tb

Answer 58

Pt are younger MDR Tb Inc in primary infections

Question 59

Can we cure Tb

Answer 59

No but we can prevent transmission

Question 60

What strains of Legionella cause diseases

Answer 60

Legionella pneumophillia and other species

Question 61

What diseases are caused by Legionella

Answer 61

Legionaires disease | Pontiac Fever

Question 62

What is the mortality of Legionnaire's disease

Answer 62

10-17%

Question 63

What is pontiac fever

Answer 63

more mild, self limiting form of Legionnaires

Question 64

What is the mortality of pontiac fever

Answer 64

0

Question 65

How is Legionnaires transmitted

Answer 65

contaminated aerosols ie cooling towers, showers, faucets, aspiration of contaminated water

Question 66

How is Legionnaire's diagnosed

Answer 66

Legionnela Ag in urine Culture DFA staining

Question 67

How is Legionnella Tx

Answer 67

macrolides and quinolones

Question 68

what viruses cause hemorrhagic fever

Answer 68

Ebola and Marburg

Question 69

What is the relative mortality of Ebola

Answer 69

High

Question 70

What is Ebola Reservoir

Answer 70

think zoonotic but not sure

Question 71

what is the relative mortality of Marburg

Answer 71

High

Question 72

how is Marburg transmitted

Answer 72

don't know how it is transmitted from animals to humans

Question 73

Hantavirus timeline

Answer 73

1-3 weeks post exposure get symptoms fever, chills, muscle aches Then abrupt onset of respiratory distress and SOB

Question 74

What is a major symptom of Hantavirus

Answer 74

Thrombocytopenia

Question 75

What is Hantavirus transmission

Answer 75

Animal to human

Question 76

How is hantavirus transmitted to humans

Answer 76

Inhalation of urine, saliva, or droppings of deer mice

Question 77

What is the most common cause of outbreaks of gastroentoritis in the US

Answer 77

Noro virus

Question 78

How is norovirus identified

Answer 78

EM

Question 79

What are the symptoms of Norovirus

Answer 79

Explosive onset but self limiting

Question 80

Key work for Norovirus

Answer 80

Cruise ships