Enteric Viruses

Question 1

what are the 5 viral enteric pathogens?

Answer 1

rotavirus

norovirus

astrovirus

adenovirus

enterovirus

Question 2

what are the 6 bacterial enteric pathogens?

Answer 2

salmonella spp.

shigella spp.

E. coli

campylobacter spp.

yersinia spp.

C. diff

Question 3

what are the 3 parasite enteric pathogens?

Answer 3

entamoeba histolytica

giardia lamblia

cryptosporidium

Question 4

what is viral gastroenteritis?

Answer 4

inflammation and irritation of stomach and small intestines

Question 5

what are the symptoms of gastroenteritis?

Answer 5

acute nausea

vomiting

Question 6

what is the onset of viral gastroenteritis?

Answer 6

1-3 days

Question 7

when is viral gastroenteritis most common (season)?

Answer 7

winter

Question 8

what replicates faster viruses or bacteria?

Answer 8

viruses

Question 9

viral gastroenteritis is most common in what age group?

Answer 9

1-10 year olds

Question 10

what are the 2 patterns of disease with gastroenteritis?

Answer 10

1. mild afebrile illness + watery diarrhea
2. severe febrile illness + watery diarrhea + vomiting + headache

Question 11

what is the major problem associated with diarrhea?

Answer 11

dehydration

Question 12

what are the 5 established pathogens for gastroenteritis?

Answer 12

1. norovirus*
2. rotavirus*
3. astrovirus
4. adenovirus
5. calicivirus

Question 13

is there a vaccine for norovirus?

Answer 13

no

Question 14

what does rotavirus cause?

Answer 14

infantile gastroenteritis

Question 15

astrovirus is especially common in the ____________ population

Answer 15

pediatric

Question 16

what are the 2 likely and emerging pathogens?

Answer 16

1.coronaviruses

2. enteroviruses

Question 17

how do coronaviruses cause gastroenteritis?

Answer 17

same receptors in RT are also in GI

Question 18

what types of enteroviruses cause gastroenteritis?

Answer 18

echoviruses
11
14
18

Question 19

what is the incubation period for norovirus?

Answer 19

24-28 hours

Question 20

what is the duration of illness for norovirus?

Answer 20

24-60 hours

quick onset and offset

Question 21

what is the incubation period for rotavirus?

Answer 21

1-3 days

Question 22

what is the duration of illness for rotavirus?

Answer 22

4-8 days

Question 23

who is at risk for rotavirus?

Answer 23

< 2 years

Question 24

norovirus is a member of the _______________ family

Answer 24

caliciviridae family

Question 25

what kind of virus is norovirus?

Answer 25

non-enveloped icosahedral SS-positive sense RNA

Question 26

describe the appearance of norovirus

Answer 26

scalloped border cupcake indentations

Question 27

how is norovirus transmitted?

Answer 27

fecal-oral person-person

Question 28

how many norovirus particles are needed for transmission?

Answer 28

~100 (very few)

Question 29

when are you longer transmissible with norovirus?

Answer 29

once you are clinically well

Question 30

what is the stability of norovirus?

Answer 30

non-enveloped, therefore highly stable

Question 31

where is norovirus shed? when?

Answer 31

in stool during first 24-48 hours of illness

Question 32

how long can norovirus be detected in stool? how is it detected?

Answer 32

detected by PCR up to 3 weeks after illness

Question 33

where are norovirus outbreaks most common?

Answer 33

closed settings - hospitals - nursing homes - cruiseships - university residences

Question 34

when do most norovirus outbreaks end?

Answer 34

spontaneously after 1-2 weeks

Question 35

How should surfaces contaminated with norovirus be cleaned?

Answer 35

high grade disinfectants soap and water doesn't work

Question 36

what are the possible vehicles for norovirus?

Answer 36

any food, especially if contact with contaminated water - shellfish - ice

Question 37

what are the signs and symptoms of norovirus?

Answer 37

abdominal cramps nausea vomiting diarrhea some have low-grade fever

Question 38

how is norovirus treated?

Answer 38

no antibitics treat symptoms fluid replacement electrolyte balance

Question 39

what are the hospital control measures for norovirus?

Answer 39

contact precautions hand washing environmental cleaning

Question 40

how long can norovirus survive on fomites?

Answer 40

21-28 days

Question 41

rotavirus is part of the ____________ family

Answer 41

Reoviridae family

Question 42

what kind of virus is rotavirus?

Answer 42

double stranded RNA non-enveloped

Question 43

what is the stability of rotavirus?

Answer 43

non-enveloped highly stable

Question 44

Rotavirus A

Answer 44

most clinically significant causes gastroenteritis in KIDS very high burden

Question 45

what is the most clinically significant rotavirus serogroup?

Answer 45

A

Question 46

Rotavirus B and C

Answer 46

causes gastroenteritis in all ages

Question 47

Rotavirus D/E/F/G

Answer 47

non-human disease

Question 48

Who is most likely to get rotavirus?

Answer 48

children < 3 years

Question 49

what is the most common cause of severe gastroenteritis in children < 5 years?

Answer 49

rotavirus

Question 50

when does the severity of rotavirus peak?

Answer 50

6 months - 2 years

Question 51

almost all kids acquire the serum antibodies for rotavirus within __________________

Answer 51

first 2-3 years of life

Question 52

where are rotavirus deaths most common?

Answer 52

Africa India

Question 53

how is rotavirus transmitted?

Answer 53

fecal-oral

Question 54

rotavirus is NOT transmitted by ___________________ in Canada

Answer 54

contaminated food and water

Question 55

how is rotavirus diagnosed?

Answer 55

detected in stool 4-10 days after symptom onset up to 57 days by PCR

Question 56

where are rotavirus outbreaks most common?

Answer 56

daycares families nursing homes hospitals

Question 57

explain the pathogenesis of rotavirus

Answer 57

malabsorption related mucosal damage and depression of disaccharides blunted villi in duodenum crypt hypertrophy and mononuclear infiltration viral enterotoxin released into environment activation of secretory reflexes in enteric nervous system causes fluid secretion

Question 58

what are the symptoms of rotavirus?

Answer 58

vomiting and fever (2-3 days) water diarrhea (4-5 days)

Question 59

how does rotavirus cause death?

Answer 59

result of dehydration and electrolyte imbalance leads to cardiac arrest

Question 60

what are the extra intestinal manifestations of rotavirus?

Answer 60

respiratory infections hepatic abscess pancreatitis myositis meningoencephalitis

Question 61

how is rotavirus treated?

Answer 61

rehydration electrolyte balance no antibiotics

Question 62

how is rotavirus prevented?

Answer 62

hand hygiene contact precautions rotavirus vaccine

Question 63

what is the dose regimen for rotavirus vaccine?

Answer 63

3 doses at 2, 4 and 6

Question 64

how long does rotavirus survive on fomites at 85% humidity? what about at 25-50% humidity?

Answer 64

up to 2 days 10 days

Question 65

what are the 2 rotavirus vaccines?

Answer 65

1. RotaTeq 2. Rotarix.

Question 66

what is the gold standard for detecting and diagnosing enteric viruses?

Answer 66

PCR

Question 67

what are some other diagnostic methods for enteric viruses?

Answer 67

electron microscopy antigen detection