Exam 5 CNS flashcards
Encaphalitis
agents in brain and spinal cord
Agents are specific for location
Viral vs bacterial meningitis
Bacterial is way worse!!
Poliomyelitis
“infantile paralysis”
Really likes the spinal cord
Clean water increased occrurance!
Polio morph
picornovirus
ACID STABLE
Three antigenic types
EXPELLED IN FECAL MATTER
Polio epi
Humans only host
Vaccines will drive to extinction
Polio path
replicates in GI tract
Spreads to CNS
Assymetric paralysis
Non polio enteroviruses
More problematic for neonates
(unlike polio)
ECHO
Coxsakie
NP enteroviruses
newborn bulgin fontanelle
Older kids and alduts get less severe meningitis
NP enteroviruses treatment
Usually won’t grow in culture
Use serology
Picovar can treat
NP enteroviruses epi/prevention
season: summer, fall
No vaccines
Wash hands
Enterovirus D68
usually mild
Can produce polio type paralysis
Common in crowded areas
LCMV
arenavirus
Two ssRNA circles
+ and ambisense
(alllows delayed transcription)
LCMV resevoir
mice
Risk for child if mom is infected
Immunocompromised
Arboviruses
mosquitos are vectors
Birds and mammals are reservoirs
Worse outcomes in kids
Late fall and summer
arbovirus id
MAC-ElISA
Doesn’t require culture
Look for IgM in CSF
Colorado Tick fever
can be detected by fluorescent assay
Or rt-PCR
Togaviruses
EEE
WEE
VEE
Flaviviruses
St Louis encephalitis
West Nile virus
Yellow fever virus
Japanese Encephalitis
Bunyavirus
California encecpalitis
(lacrosse)
Most common in midwest
EEE
east of mississippi
Horses
(infected but not risk factor)
Kids under 15, adults ages over 55
swamps
WEE
pediatric cases
Unpredictable season
Common in farms
st louis enecp
Midwest
Summer-fall
Mosquito vector, bird resevoir
Sparrows
Low economic status
west nile virus
flavivirus
Some antigenic sim w/ StLE
Greatest risk for age > 50
Result or air travel
WNV disease
can paralyze like polio
Measles like syndrome w/ rash
Neuronphagia of anterior horn
WNV detection/treatment
spread by blood transfusion, mosquito bites
Check IgM antibodies
Japanese Enceph
Vaccine available
(military)
Can amplify in herd animals
California E
lacrosse
kids that play outside
Unique daytime feeding mosquito
Colorado Tick fever
Tick
Small mammal reservoir
(summer)
Similar to rotavirus
SADDLEBACK FEVER (up and down)
WEE
chimera
EEV and Sindibis
Rabies virus
dogs are bridge vector
Rabies virus vaccine
Use virus to infect animal
Collect antibodies
Viruses that go retrograde to CNS
Polio, rabies, HSV
Rabies Clinical
2 year incubation
Where bite was determines length
Prodrome: fever etc
Excitatory phase: “hydrophobio”
-swelling of throat causes painful swallowing
Rabies Pathology
Negri bodies (eosinophils in cytoplasm)
Rabies epidemiology
global distribution
Small mammals
Bats!
Rabies transmission
not only bites, can just be contact
Aerosol transmission
Milwuakee Protocol
Induce coma, give adamantine
Rabies Control
prophylaxis, avoid animals
Rabies prophylaxis
HRIG vaccine into wound,
Then 4 shots in deltoid over 4 weeks
Herpes Simplex Virus
Most common fatal encephalitis in US
HSV-1 death usually from reactivation
And attacking frontal/temporal lobe
HSV-1
Casual contact early in life
HSV-2
from sex
HSV treatment
treat newborn with acyclovir if suspected
acyclovir treatment
stop virus polymerase from DNA rep
Prions
“slow virus infections”
Ex: scrapies and visna
Get into brain and change animal behaviour
Dementia in humans
Transmissable spongiform encepalopathies
SPEs
sheep: scrapie
Cows: mad cow
Humans: CJD