Hemorrhagic Fevers Flashcards

1
Q

Common features from viral hemorrhagic fevers

A

Affect multiple organs

Damages blood vessels widespread

Affects body’s ability to regulate itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Main families of viral hemorrhagic fevers

A

Arenaviridae
- lassa , junin and machupo

Bunyaviridae
- Rift Valley, Bataan and Congo

Filoviridae
- Ebola and Marburg

Flaviviridae
- yellow and dengue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Arenaviridae

A

Generally rodent transmitted via urine or droppings with humans not being a part of the life cycle normally (zoonotic)

2 segmented single strands of RNA genome that is enveloped

Often seen in west Africa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lassa virus

A

Caused by arenaviridae

Acute viral hemorrhagic illness that lasts 2-21 days

Endemic to west Africa

Easily supportive care with rehydration and symptomatic treatment (very low fatality rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bunyaviridae

A

Large single strand 3-segmented RNA virus that is enveloped

Transmitted via Arthropods and rodents and is a zoonotic virus

Possess:
-the Crimean-Congo hemorrhagic fever (transmitted by ticks and can be transmitted by humans once infected)

  • Hantaviruses (Sin Nombre Virus)
  • Rift Valley fever (transmitted by mosquitoes and is endemic to sub-Saharan Africa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Filoviridae

A

Cause severe hemorrhagic fever in humans and nonhuman primates

Single stranded, negative-sense RNA that is enveloped

  • have segmented parts called virions that have multiple various shaped filaments (can be branched/long)
  • often looks 6 or U shaped*

Produce Marburg and Ebola

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Marburg and Ebola

A

Caused by filoviridae

Severe often fatal illness in humans (produce the highest mortality rates in hemorrhagic fevers)

Transmitted to mammals from fruit bats and then can be spread via human-human transmission

No cure but supportive care improves survival

Marburg mortality rates hover around 50%

Ebola mortality rates can be as high as 90% or as low as 20%

Survivors produce side effects such as tiredness, muscle aches, eye and vision problems and stomach pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ebola risk of infection and resistance

A

Super high chance if in close contact with infected person (3ft-1 meter)

Otherwise low risk

Can remain in areas of the body that are immunologically privileged and body fluids for days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ebola investigational treatments

A

Regeneron (REGEN-EB3) and mAb114

Induces overall higher survival rates but not always recommended
- only for confirmed not early stages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Vaccine for Ebola virus

A

Ervebo
- “host virus” that contains Ebola glycoprotein with very low lethality

  • allows for body to produce antibodies/ memory of Ebola specific glycoproteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cells that Ebola target

A

Monocytes and dendritic cells
- as well as lymphocytes indirectly

Leads to cytokine storm, poor stimulation of T helper cells, lymphocyte apoptosis and low antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Flaviviridae

A

Positive, single-stranded RNA virus that is enveloped

Infects via arthropods

Mosquitoes = yellow, dengue, Zika and west Nile

Ticks = Omsk and tick borne encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Yellow fever virus

A

Flaviviridae virus Transmitted via infected mosquitos and found usually in subtropical areas

Symptoms:

  • fever aches and pain (acute)
  • liver disease w/ bleeding and jaundice (chronic)
  • yellow vomiting with the jaundice

Treatment: vaccination
- attenuated vaccine single dose that provides lifelong protection

  • if allowed to enter chronic stage, mortality rate is 30-60%*

Primarily Africa and South America

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

transmission Cycles of yellow fever virus

A

Jungle (sylvatic)
- mosquitoes -> non human mammals

intermediate (Savannah)
Mosquitoes -> humans in jungle areas

urban

  • special mosquito called aedes aegypti
  • mosquitoes-> humans in urban areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dengue virus

A

Flavivirideae virus with 4 serotypes
- DENV1-4 (allows for up to 4 different infection chances)

Mosquito borne infection that is increasing in incidence
- severe dengue is the leading cause of death amount children in Asian countries

  • one of the only hemorrhagic fevers that humans can be the primary host/ infectious agent*

no treatment just palliative care
-AVOID NSAIDS (causes liver issues)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dengue virus symptoms

A

Wide spectrum including severe flu like symptoms, myalgia and nausea

Severe dengue symptoms occur in chronic stage of disease
- severe bleeding, organ failure and plasma leakage are added on top of the severe flu-like symptoms

17
Q

When to suspect dengue fever

A

History: person traveled to location known for dengue and now presents with fever/flu-like symptoms

  • highly suspect if presents with high fever (40C) and 2 of the following symptoms*
  • severe headache
  • pain behind the eyes
  • muscle and joint pains
  • nausea
  • vomiting
  • swollen glands
  • rashes
18
Q

Critical phase of dengue

A

Most fatal point in chronic severe dengue

  • develops plasma leaking, edema, respiratory distress, hemorrhages and organ failure
  • produces 3-7 days after major high fever
  • warning signs of severe dengue*
  • ab pain
  • persistent vomiting
  • rapid breathing
  • bleeding of gums
  • fatigue
  • blood in vomit
  • restlessness
19
Q

Dengue virus vaccine

A

Live attenuated dengue vaccine

  • only give to patients that are seropositive for dengue fever ( must have already had dengue fever)
  • increases risk of severe dengue in seronegative populations

Requires pre-vaccination screening because of this

20
Q

What classes of hemorrhagic fever pathogens possess segmented genomes

A

Bunyaviridae (most segmented genome)
- Rift Valley fever

Arenaviridae
- lasso fever

21
Q

What classes of hemorrhagic fever pathogens possess non-segmented genomes

A

Filoviridae

- Ebola and marburg

22
Q

Most common type of arenaviridae in US?

A

Lymphocytic choriomengitis virus (LCMV)

Causes meningitis, not as dangerous as lassa fever but lassa is not indigenous to the US

23
Q

Rift Valley fever virus

A

Endemic to Africa

Viral zoonotic virus that is transmitted by mosquitoes (and humans once infected)

Treatment is palliative care and prophylaxis actions such as vaccinating animals
- doesn’t usually kill as long as palliative care is given

24
Q

What is the most lethal hemorrhagic fevers?

A

Ebola and Marburg

- specifically Ebola

25
Q

Ebola virus persistence

A

Survives very well on dry surfaces and can often remain in immunologically privileged areas.

In body fluids can survive up to several days at room temperature

26
Q

aedes aegypti and aedes albopictus

A

Two types of mosquitos that are the most common vectors for dengue virus

  • aegypti also does yellow fever as well
  • albopictus species is more dangerous to the US since their spread is more US friendly and is less temperature sensitive)
27
Q

Tests to use for dengue fever

A

Before 7 days after symptom onset

  • molecular tests
  • dengue virus antigen detection
  • serologic tests
  • tissue tests

After 7 days from symptom onset

  • serologic tests
  • tissues only

Serum is used for all tests except tissue

  • cerebrospinal fluid is used only for molecular tests*