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MID Exam 3 > Exam 3 - Vectors-Emerging > Flashcards

Exam 3 - Vectors-Emerging Flashcards

1
Q

Arbovirus

Definition

A
  • arthropod vector
  • vertebrate host
  • humans usually incidental (“dead end”)
  • St Lous Encephalitis Virus Transmiss Cycle?
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2
Q

Arbovirus

morph

A

-spherical RNA

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3
Q

Arbovirus

4 imp’t families

A
  • flaviviridae
  • togaviridae
  • bunyaviridae
  • reoviridae
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4
Q

Arbovirus

imp’t togaviridae

A

-chikungunya

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5
Q

Arbovirus

imp’t flaviviridae

A
  • dengue
  • yellow fever
  • west nile
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6
Q

Arbovirus

epidem. defintions

A
  • endemic: habitual presence
  • epidemic: higher than usual
  • pandemic: worldwide
  • hyper-epidemic: several strains co-infect.
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7
Q

Arbovirus

NA encephalitic

A
  • moquitoe vector (except Colorado Tick)
  • bird, small mammal res
  • asx, flu-like, meningitis (CNS), flacc paralysis
  • dx CSF IgM
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8
Q

Arbovirus
Flavivirus
West Nile epi

A
  • ‘squito (culex pipens….. umm, okay)
  • bird res, Long Island horsies
  • don’t be old or have AIDS
  • intro’d to US in 1999 (Queens)
  • moves N in spring, S in winter
  • less fatal in tropics
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9
Q

Arbovirus
Flavivirus
West Nile clin/sx

A
  • 2-14 day incubation
  • 80% asx
  • West Nile Fever (nausea, vomit, neck stiff, macpap rash)
  • West Nile Meningitis (CN palsy, elevated CSF protein, normal glc)
  • West Nile Encephalitis (20% fatal, arrhythmia, resp failure, neuro sequelae)
  • West Nile Neuroinvasive Dz (eith WMN or WNE) rare
  • West Nile Flaccid Paralysis (w/ enceph, assymetric, prolonged recovery)
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10
Q

Arbovirus
Flavivirus
West Nile dx

A
  • CSF IgM (WNND) or blood IgM

- IgM after onset of encephalitis

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11
Q

Arbovirus
Flavivirus
West Nile tx

A

supportive

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12
Q

Arbovirus
Flavivirus
Dengue epi

A
  • human are main res! that’s weird!
  • peri-domestic transmission (urban)
  • ‘squito vector (female aedes aegypti, day feeder)
  • can also persist in sylvatic habitat
  • tropical
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13
Q

Arbovirus
Flavivirus
Dengue path

A

-ADE: antibody-dependent enhancement
-heterologous subsequent infx’n complexes w/
old antibodies
-complexed virus enhanced entry to monocytes
-vasoactive mediators released by monocytes

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14
Q

Arbovirus
Flavivirus
Dengue Fever clin pres

A
  • 20-50% asx
  • Dengue Fever Syndrome
  • Dengue Hemorrhagic Fever
  • Dengue Shock Syndrome
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15
Q

Arbovirus
Flavivirus
Dengue Fever

A

-fever, nausea, retro-orbital pain,
diffuse erythematous macpap rash,
rash blanches

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16
Q

Arbovirus
Flavivirus
Dengue Hemorrhagic Fever

A

-fever, hemorrhages, thrombocytopenia (s)

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17
Q

Arbovirus
Flavivirus
Dengue Shock Syndrome

A

-DHF plus circulatory failure

18
Q

Arbovirus
Flavivirus
Dengue DHF/DSS tx

A

ADMIT TO ICU!

-volume replacement, avoid overload

19
Q

Arbovirus
Flavivirus
Dengue Dx

A
  • tourniquet test (>20 petechiae)
  • RT-PCR
  • IgM after 5 days of onset
20
Q

Arbovirus
Flavivirus
Yellow Fever epi

A

-equatorial spread in Africa, S America

21
Q

Arbovirus
Flavivirus
Yellow Fever clin/sx

A
  • 3-6 day incubation
    1) 3 day fever, back myalgia, conjunctival suffusion
  • biphasic recurrence
    2) severe hemorrhage, hepatitis, renal failure blk hematemesis
22
Q

Arbovirus
Flavivirus
Yellow Fever dx

A

-IgM

23
Q

Arbovirus
Flavivirus
Yellow Fever tx

A

-supportive

24
Q

Arbovirus
Flavivirus
Yellow Fever prevention

A

-very effective live-atten’d vaccine, single dose

25
Q

Arbovirus
Togavirus
Chikungunya epi

A
  • Aedes ‘squito vector
  • Africa (coastal Kenya epicenter)
  • in central america, too
26
Q

Arbovirus
Togavirus
Chikungunya clin/sx

A
  • asx sometimes
  • biphasic
    1) 3 days fever, rash, arthralgia, facial edema
    2) polyarthralgias, spinal pain, tenosynovitis, Reynaud’s
    3) Recovery after months
27
Q

Arbovirus
Togavirus
Chikungunya dx

A

IgM or IgG; RT-PCR

28
Q

Arbovirus
Togavirus
Chikungunya tx

A

supportive/symptomatic

29
Q

Coronavirus

SARS epi

A
  • ssRNA SARS-CoV
  • from Chinese bats, civets 2002
  • rapid global spread
30
Q

Coronavirus

SARS transmiss

A
  • mucous mem contact w/ droplets, fomites

- nosocomial

31
Q

Coronavirus

SARS clin/sx

A
  • early: fever, myalgia, dry cough

- late:severe atypical pneumonia, diarrhea

32
Q

Coronavirus

SARS dx

A

RT-PCR from lower resp, stool

33
Q

Coronavirus

SARS tx

A

supportive

34
Q

Coronavirus

SARS prevention

A

ISOLATION!!!!!!!!!!!!!!!!!
BORDER CONTROL!!!
RACIAL PANIC!!!!!!!!!!!!

35
Q

Coronavirus

MERS epi

A
  • MERS-CoV
  • Arabian peninsula, camels (of course)
  • spread to healthcare workers
36
Q

Coronavirus

MERS clin/sx

A
  • fever, cough, SOB, diarrhea, vomit

- 45% mortality, esp w/ comorbidity

37
Q

Coronavirus

MERS dx

A

RT-PCR from lower resp, stool, blood

38
Q

Coronavirus

MERS tx

A

BLEEEAK!

39
Q

Filovirus

Ebola epi

A
  • 1976 Sudan/DRC
  • 2014 Liberia/Sierra Leone/Guinea
  • res unknown (fruit bats?)
  • person-person transmiss from body fluids
  • contagious while febrile through post-mortem
40
Q

Filovirus

Ebola clin/sx

A
  • 2-21 day incubation
  • abrupt fever, chills, malaise, myalgia
  • multisystem progression (“Ebola Virus Dz”)
  • hemorrhagic petechiae, viscera
  • macpap rash, desquamates in survivors
  • shock, seizures, coagulopathy
  • 59% fatal w/in about 10 days
  • strong inflamm response-> good prognonis

MID Exam 3 (13 decks)

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