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Microbiology > Hepatitis A Epidemiology > Flashcards

Hepatitis A Epidemiology Flashcards

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1
Q

Hepatitis A Epidemiology

Seropositivty varies from country to country
- In endemic, developing countries, seropositivty often ..%

Treatment. Immune …… ……… given in the early …………. period can prevent symptoms

vaccine available for travellers

A

Seropositivity varies from country to country.
In endemic, developing countries, seropositivity often 90%
Treatment. Immune serum globulin given in the early incubation period can prevent symptoms.
Vaccine available for travellers

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2
Q

Hepatitis viruses

Hepatitis A and B best known, but several NANBH recognised
- Now C, D and E

All affect liver, causing …… and release of ….. enzymes
- Viral ……

Course nature and serology differs for each type

all ……..

A

Hepatitis A and B best known, but several NANBH recognised
Now C, D and E.
All affect liver, causing jaundice and release of liver enzymes.
Viral hepatitis
Course nature and serology differs for each type.
All contagious.

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3
Q

Hepatitis A

Infectious hepatitis

Caused by a picornavirus

  • single stranded …… sense ……….
  • ……….. virus

Only one serotype

Interacts specifically with receptor on l….. cells and few other types

A

Infectious hepatitis

Caused by a picornavirus

  • single stranded …… sense ……….
  • ……….. virus

Only one serotype

Interacts specifically with receptor on l….. cells and few other types

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4
Q

Hepatitis A Pathogenesis

Ingested and enters bloodstream via oropharynx or ………… ……… of intestine and reaches parenchymal cells of the ….
- Incubation period 4 weeks (2-6 weeks)

Virus reproduces, excreted in …. and passed out in s……

Virus shed 10 days before onset of symptoms

A

Ingested and enters bloodstream via oropharynx or epithelial lining of intestine and reaches parenchymal cells of the liver.
Incubation period 4 weeks (2-6 weeks).
Virus reproduces, excreted in bile and passed out in stool.
Virus shed 10 days before onset of symptoms.

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5
Q

Hepatitis A Pathogenesis

Replicates slowly in liver,
- Jaundice occurs when immune system …… and damages ….. cells ]

Symptoms ..-..dys after infection

Fever …….., nau….. and abdominal pain

Viral ………. stops before symptoms disappear.

No chronic infection and no association with liver cancer
- …….. …………

A

Replicates slowly in liver,
Jaundice occurs when immune system active and damages liver cells.
Symptoms 15-50dys.after infection.
Fever malaise, nausea and abdominal pain.
Viral shedding stops before symptoms disappear.
No chronic infection and no association with liver cancer.
Lifelong immunity.

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6
Q

Hepatitis A Epidemiology

Causes 40% causes of acute hepatitis

Virus released in large quantities in ……

Large percentage of people have inapparent infection but very contagious in ……..

-
-

HAV is resistant to acid at pH .., solv…. and det…….., drying and salt water

A

Causes 40% cases of acute hepatitis.
Virus released in large quantities in stools.
Large percentage of people have inapparent infection but very contagious.
Spread by food, water, dirty hands.
HAV is resistant to acid at pH 1, solvents and detergents,drying and salt water.

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7
Q

Hepatitis A Epidemiology

Survives range of temperature

Inactivated by …., f….. and UV ……..

Outbreaks from common source

Related also to poor ….. and ………

In endemic countries, children have ………….. infection and life long immunity

A

Survives range of temperature.
Inactivated by chlorine, formalin and UV radiation.
Outbreaks from common source.
Related also to poor hygiene and overcrowding.
In endemic countries, children have asymptomatic infection and life long immunity

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8
Q

Hepatitis E

Small single stranded RNA virus,
- Probably a calici……

Spread by ……. oral route and excreted in ……

Waterbourne infection, particularly in India.

May be cause of ….. of ….. hepatitis in developing countries

A

Small single stranded RNA virus,
Probably a calicivirus.
Spread by faecal oral route and excreted in faeces.
Waterborne infection, particularly in India,
May be cause of 50% sporadic hepatitis in developing countries

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9
Q

Hepatitis E

Incubation period …..-….. weeks

mild disease except in pregnant women

High mortality ,
- Disseminated i…………… c …………. during third ………….

No carriers
- Virus eliminated

A 
Incubation period 6-8 weeks.
Mild disease except in pregnant women.
High mortality, 
Disseminated intravascular coagulation during third trimester.
No carriers, 
Virus eliminated
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10
Q

Hepatitis B

Serum hepatitis
- Caused by hepadnavirus

Enveloped, partially double stranded circular DNA genome. Has reverse transcriptase

Limited tissue specificity specificity
- Liver, kidney and pancreas of humans and chimpanzees

Virion called …… ………….

A

Serum’ hepatitis.
Caused by hepadnavirus.
Enveloped, partially double stranded circular DNA genome. Has reverse transcriptase.
Limited tissue specificity
Liver, kidney and pancreas of humans and chimpanzees.
Virion called Dane particle.

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11
Q

Hepatitis B

Virion surrounded by core antigen HbcAg

Envelope containing glycoprotein surface antigen Hb..Ag

Also has Hb..Ag e and c share most of their …….. sequence

Hb..Ag particles released into serum and outnumber virions
- Immunogenic

A

Virion surrounded by core antigen HbcAg.
Envelope containing glycoprotein surface antigen HbsAg.
Also has HbeAg e and c share most of their protein sequence.
HbsAg particles released into serum and outnumber virions.
Immunogenic.

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12
Q

Hepatitis B

3 forms of HbsAg proteins.

Transcription of DNA in nucleus

Replication : attachment via HbsAg proteins

Replication of genome in cytoplasm

HBV and surface antigen released into serum

A

3 forms of HbsAg all found in virion.
Replication : attachment via HbsAg proteins.
Transcription of DNA in nucleus.
Replication of genome in cytoplasm.
HBV and surface antigen released into serum.

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13
Q

Hepatitis B pathogenesis

Capable of causing acu…, chr…, sym………… or asy………… disease

Determined by patient immune response to the infection

Presence of .. and surface antigen in serum indicates active infection

Surface antigen released until ….. of disease

A

Capable of causing acute, chronic, symptomatic or asymptomatic disease.
Determined by patient immune response to the infection.
Presence of e and surface antigen in serum indicates active infection.
Surface antigen released until resolution of disease.

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14
Q

Hepatitis B pathogenesis

Source of infection:
- Blo.., s.., mi….., va…….., and menstrual secretions and am……. fluid

IV injection very…….. Also spread by SI and birth

Low infective dose and high …….

Replicates……. acquisition, but no symptoms for … days or longer

A

Capable of causing acute, chronic, symptomatic or asymptomatic disease.
Determined by patient immune response to the infection.
Presence of e and surface antigen in serum indicates active infection.
Surface antigen released until resolution of disease.

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15
Q

Hepatitis B pathogenesis

Depends on infectious dose, route of infection and host immune system.

copies of virus genome …….. and become ……..

Cell mediated immunity responsible for outcome of disease.

Immune complexes can cause ……………. reactions.
- Milder symptoms in ………..

A

Depends on infectious dose, route of infection and host immune system.
Copies of virus genome integrate and become latent.
Cell mediated immunity responsible for outcome of disease.
Immune complexes can cause hypersensitivity reactions.
Milder symptoms in children.

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16
Q

Hepatitis B ….. infected at birth become chronic carriers

During acute phase, ….. damage and ……. cell infiltration

Problems in long term, especially if co-infection with ……. …….

Can lead to … and hepatic …….

A

90% children infected at birth become chronic carriers.
During acute phase, liver damage and inflammatory cell infiltration.
Problems in long term, especially if co-infection with delta virus.
Can lead to cirrhosis and hepatic carcinoma.

17
Q

Hepatitis B Epidemiology

High rates of ……. in many countries
- Up to … infected during birth or ……

In parts of Africa and Asia, seropositivity is up to ….
- High levels of Hepatic carcinoma. 80% attributed to chronic ……

Chronic infection in ..-..% of those infected

A

High rates of seropositivity in many countries.
Up to 15% infected during birth or childhood.
In parts of Africa and Asia, seropositivity is up to 50%.
High levels of Hepatic carcinoma. 80% attributed to chronic HBV
Chronic infection in 5-10% of those infected

18
Q

Hepatitis delta

15 million infected with Hepatitis delta

Uses HBV and ……. ……..
proteins to r……. and produce its one protein

Viral ……
Similar transmission to HBV,
- Makes … more severe

A

15 million infected with Hepatitis delta.
Uses HBV and target cell proteins to replicate and produce its one protein.
Viral parasite.
Similar transmission to HBV,
Makes HBV more severe.

19
Q

Hepatitis C

90% of non A non B hepatitis C
- ……virus

Spread ………….. and sexually
- .. ….. abusers, transfusion and organ recipients and ………….

chronic asymptomatic infections leading to ….. in 20% of cases

A

90% of non A non B hepatitis is caused by Hepatitis C.
Flavirus.
Spread parenterally and sexually.
IV drug abusers, transfusion and organ recipients and haemophiliacs.
Chronic asymptomatic infections leading to cirrhosis in20% of acute cases.

20
Q

Hepatitis C

Viraemia …-…. weeks post transfusion, lasting 4-6 …..
- up to 10 years

Causes chronic persistent …… and …… failure

Cell mediated pathology causes …… damage

Treatment, recombinant ………. alpha

A

Viraemia 1 - 3 weeks post transfusion, lasting 4-6 months.
Up to 10 years.
Causes chronic persistent hepatitis and liver failure.
Cell mediated pathology causes liver damage.
Treatment, recombinant interferon alpha.

21
Q

Viral Gastroenteritis

Significant cause of infant gastroenteritis

causes death infant and young children in . ……… countries
- 5-10 million a year in asia africa and latin america

……….. transmission.

1972 virus particles seem on …. examination of faeces

A

Significant cause of infant gastroenteritis.
Causes death in infants and young children in developing countries
5-10 million/year in Asia, Africa and Latin America.
Faecal -oral transmission.
1972 virus particles seen on EM examination of faeces.

22
Q

Rotavirus

Characterstic viruses
- 65nm particles

Cubic …….., ………. coat arranged like the spokes of a wheel

At least 2 humans serotypes
- Also found in kittens puppies, calves foals and piglets

Epidemics in young children espeically the …….. months

A

Characteristic viruses.
65nm particles.
Cubic symmetry, capsid coat arranged like the spokes of a wheel.
At least 2 human serotypes.
Also found in kittens puppies, calves foals and piglets.
Epidemics in young children, especially in the winter months.

23
Q

Rotavirus - Pathogenesis

Very low infective dose:

-10 particles

Incubation period ……..

Viral replication in ….. …….. cellls leads to acute onset of vomitting and diarrhoea

1000 million/gram virus particles ……..

Respiratory symptoms also common

A

Very low infective dose:
10 particles.
Incubation period 1-4 days.
Viral replication in intestinal epithelial cells leads to acute onset of vomiting and diarrhoea.
1000 million/gram virus particles excreted.
Respiratory symptoms also common

24
Q

Rotavirus-Treatment and Prevention

Rehydration

No treatment available

Other viral GIT infections caused by:

Calic,,,,

astro. ..
aden. ….

small round ……

parovi…..

Coro……..

A 
Rehydration.
No treatment available.
Other viral GIT infections caused by:
Caliciviruses (Norwalk), 
Astroviruses, 
Adenoviruses , 
Small round structured viruses, 
Parvoviruses 
Coronaviruse

Microbiology (13 decks)

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