Hospital-acquired Viral Infections Flashcards
What are blood-borne viruses capable of doing? (2)
Persistent viremia or carrier state
Example of blood-borne viruses (3)
Hepatitis B
HIV
Hepatitis C
How to control the spread of HBV? (2)
HBV immunization and monitor health status if HCW
Non-responders to vaccine offered Hepatitis-B specific immunoglobulin following exposure to positive patient
How to control spread of HIV? (1)
Antiretroviral drug —> POST EXPOSURE PROPHYLAXIS (continue for 4 weeks)
How can viral hemorrhagic fevers spread? (4)
Spread from person to person through direct contact with:
1- Symptomatic patients
2- Body fluids
3- Cadavers
4- Inadequate infection control in hospital
Why do respiratory acquired viruses result in significant nosocomial problems? (2)
1- Ease of spread
2- Short incubation period (1-8 days)
Respiratory Syncytial Virus (RSV) (2)
1- Survives >5 hours on surfaces
2- Paediatric wards —> common problem (40% infected in winter)
Influenza Viruses (2)
1- Key —> Immunize HCW
2- Severely affects Elderly and Immunocompromised
Rhinoviruses (3)
1- Average child —> 4-8 episodes per year
2- Outbreaks at paediatric ward —> Considerable illness and death
3- Premature neonates and children with chronic diseases or Immunocompromised —> Serious
Parainfluenza Viruses (4)
1- Type 1 and 2 —> Upper respiratory tract
2- Type 3 —> Nosocomial infections and bronchiolitis/pneumonia
3- Non-absorptive surface (e.g. stainless steel) —>10hrs
4- Absorptive surface (e.g. lab coats and gowns) —> 4hrs
Adenovirus (2)
1- Following reaction —> can be acquired both exogenously and endogenously
2- Seen throughout year
Coronaviruses (2)
1- Upper Respiratory Tract
1- Alpha coronaviruses
2- Beta coronaviruses
- cause 5-10% of overall common cold / URT cases
- cause 30% of overall common cold outbreaks
2- Lower Respiratory Tract 1- MERS 2- SARS - SARS-CoV-1 -SARS-CoV-2
Who’s most at risk for SARS-CoV-1?
Healthcare workers
SARS-CoV-2 (2)
1- Covid-19
2- Key —> Immunize Healthcare workers
What is unexpected about Measles, Mumps, and Rubella?
As incidence of these infections fall, the risk of nosocomial infections increases, due to failure to recognize these infections in early stages
Measles Virus (2)
Highly contagious (90% of susceptible close contacts will be infected) Immunocompromised —> Severe measles (mortality = 70%)
Mumps Virus (4)
Common childhood disease
Characterized by swelling of parotid glands, salivary glands, and other epithelial tissues
High morbidity and in some cases severe complications —> Deafness
Significant outbreaks in recent years
Rubella Virus (3)
Often mild (Half people don’t realize they are sick)
Complicated by —> Encephalitis and Thrombocytopenia
Infection during early pregnancy—> Congenital rubella syndrome or miscarriage
Parvovirus B19 (2)
Most susceptible —> Immunocompromised, SS disease, Anemia, and pregnant women
Decrease dose of immunosuppressive agents —> Sufficient IgG —> Lifelong protection
Herpes Simplex Virus (4)
Most efficient transmission —> Direct contact with lesions or Saliva
Contamination of hands
Neonatal Herpes —> Mother to baby —> During delivery
Reduce risk of infant —> Caesarean section
Cytomegalovirus (5)
Direct contact with body fluids —> Vaginal secretions, semen, saliva, whole blood
Primary infection —> Asymptomatic but some —> Glandular fever-like illness
Hospital setting —> Children transmission
Common —> Asymptomatic reactivations
Immunocompromised—> Primary infection and reactivation of LATENT virus
EBV, HHV6, HHV7, HHV8
EBV, HHV6, HHV7 —> Oropharynx shedding
Varicella Zoster Virus (4)
Droplet spread from respiratory secretions (chickenpox)
Contact with infected lesions (chickenpox and shingles)
Highly infectious
Patients with chickenpox infectious via respiratory route for 2 days before rash appears until it crusts over (usually 5 days)
Control Measures for Herpesviruses (5)
Nosocomial unusual —> Except for VZV
Chickenpox (and shingles) —> Negative pressure rooms
VZVIF —> High risk
Acyclovir —> Prophylactically and/or therapeutically
VZV live-attenuated vaccine —> Prophylactically for patients at risk
Rotavirus (4)
Important cause of Nosocomial infection —> In infants and children >5 years, elderly, and Immunocompromised
In outbreaks —> shed in stool
50% of all cases of nosocomial acquired infectious gastroenteritis in pediatric patients
Two new vaccines —> Rotarix and RotaTeq
Small Round-Structured Viruses (3)
Norwalk virus, Calcivirus, and Astrovirus
Outbreaks of gastroenteritis —> in schools, families, cruise ships, and hospitals (involve any age group)
Widespread transmission —> ward or clinical setting
Enteroviruses (5)
Coxsackieviruses, Echoviruses, Polioviruses, and Enteroviruses 68 to 71
Shedding continues for 1 month after infection
Common in general population
Problematic —> Neonatal units and nurseries
During delivery —> transmission from infected mother to newborn —>index case of an outbreak —> Meningitis, Encephalitis, Myocarditis
Hepatitis A Virus (5)
Nosocomial transmission —> Poor hygienic conditions and crowded wards
Transmission in hospital wards —> Unusual
Transmission —> contact with Asymptomatic or symptomatic patient with vomiting/diarrhea
Food-borne outbreaks in hospitals
Administer normal immunoglobulins and apply immunization to prevent HAV in susceptible