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Unit 2 Micobio > L15: Viral infections of nervous system > Flashcards

L15: Viral infections of nervous system Flashcards

1
Q

Aseptic meningitis:

A

named due to failure to isolate the bacteria from the patient as its viral
Fever, HA, stiff neck. Mild disease

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2
Q

Encephalitis:

A

more CNS symptoms and objective signs: seizures, visual disturbances, paralysis of extremities

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3
Q

Poliovirus is a

A

Picornavirus, enterovirus

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4
Q

poliovirus infection MOA

A

Multiplies in pharynx and small intestine→ viremia→ spreads to draining lymph nodes→ CNS: Anterior horns of cells of spinal cord and motor cortex (bulbar motor nuclei) of brain

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5
Q

Classic polio presentation

A

asymmetric, flaccid paralysis of extremities

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6
Q

Polio: Inapparent infection

A 
Most common (90%) 
Asymptomatic to minor malaise
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7
Q

Polio: Abortive illness

A

(4-8%)

Fever, malaise, drowsiness, N/V

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8
Q

Polio: Nonparalytic poliomyelitis

A

(1-2%)

Fever, malaise, drowsiness, N/V, stiff neck, back

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9
Q

Polio: paralytic myelitis

A

(<1%)

Lower motor neuron damage→ flaccid paralysis

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10
Q

Post polio syndrome

A

Muscle weakness, pain, and fatigue 30-40 years after acute case of paralytic polio→ many patients today
Remaining motor units of CNS now react to overuse?

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11
Q

antigenic types of polio virus

A

3

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12
Q

Inactivated polio vaccine (IPV) (Salk)

A

Formalin inactivation of virus grown in monkey kidney culture

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13
Q

Live polio vaccine (Sabin) (trivalent oral polio vaccine: OPV)

A

Live attenuated virus grown in primary monkey or human diploid cell cultures
→ Infects, multiplies, and immunizes recipient
→ Vaccine virus ends up in community→ can back mutate to the paralysis causing state: no longer in use in US due to risks

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14
Q

Arboviruses come from

A

arthropods

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15
Q

Arbovirus vectors

A

mosquitos, ticks required to complete life cycle

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16
Q

Arbovirus animal reservoirs

A

birds, small mammals→ may no show overt disease

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17
Q

Arbovirus dead end hosts

A

humans

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18
Q

Arbovirus presentation is most commonly

A

Subclinical: most patients unaware of infection

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19
Q

Overt arbovirus infection

A

abrupt onset of fever, HA, vertigo, photophobia, N/V, confusion, personality changes, focal/general seizures

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20
Q

Overt arbovirus infection prognosis

A

complete recovery or long term deficits

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21
Q

How to diagnose an arbovirus infection

A

“Diseases of specific place and time”

Diagnosis: age, location, time of year of infection, travel, vaccination history

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22
Q

Prevention of arboviruses

A

Avoid infection

Interrupt chain of transmission

Avoid exposure: window screens, insect repellents

Immunize nonhuman amplifying hosts (if possible)

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23
Q

Zika prevention

A

avoiding mosquitos, education
Usually travel-related infection
Delay pregnancy after infection

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24
Q

West nile diagnosis

A

MAC-ELISA

IgM

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25
Q

IgM MAC-ELISA for West Nile with show cross reactivity with

A

yellow fever, dengue, zika, St. Louis encephalitis, Japanese encephalitis viruses

Yellow fever and japanese encephalitis→ long time for detectable reactive IgM

26
Q

serum sample MAC-ELISA of west nile will show

A

reveals recent infections and yellow fever vaccination

27
Q

CSF sample MAC-ELISA of west nile will show

A

IgM doesn’t cross blood brain barrier, (+) result is much more likely to reveal cause of encephalitis

28
Q

How to diagnose Zika

A

MAC ELISA

PCR

29
Q

IgM MAC-ELISA for Zika with show cross reactivity with

A

antigenic cross reaction with yellow fever, dengue, west nile

30
Q

Zika is spread by

A

mosquitos, possible STI

31
Q

Zika causes

A

birth defects if mother is infected

Guillain-Barre syndrome (GBS)

32
Q

West nile is

A

emerging, mosquito-borne infection in North America→ encephalitis

33
Q

Where is West Nile found?

A

Permanently established in US→ Repeated large scale outbreaks

34
Q

Togaviridae group

A

Ss (+) RNA, small (40 nm), enveloped

Subgroup: Alphaviruses

35
Q

Eastern Equine Encephalitis (EEE)

A

alphavirus

36
Q

Western Equine Encephalitis (WEE)

A

alphavirus

37
Q

Venezuelan Equine Encephalitis (VEE)

A

alphavirus

38
Q

Alphaviruses are

A

subgroup of togaviridae group

39
Q

St. Louis encephalitis

A

Flaviviridae group

40
Q

West Nile Virus

A

Flaviviridae group

41
Q

Dengue virus

A

Flaviviridae group

42
Q

Zika virus

A

Flaviviridae group

43
Q

3 subgroups of Arboviruses

A
  1. Togaviridae group
  2. Flaviviridae group
  3. Bunyaviridae group
44
Q

California encephalitis virus (LaCrosse)

A

Bunyaviridae group

45
Q

Rabies morphology

A

Unique bullet shaped virion:
ssRNA
Envelope, matrix protein, glycoprotein, ribonucleoprotein

46
Q

rabies is found

A

Global distribution: rabies free areas: Australia, Antarctica, Great Britain

47
Q

Domestic dogs are a rabies reservoir in

A

Africa, South america, Asia, india

48
Q

Feral animals are a rabies reservoir in

A

Europe, Canada, USA

49
Q

USA rabies reservoirs

A

skunks, racoons, foxes, bats

→ carnivores

50
Q

Bats and rabies

A

Bats: dangerous: minor scratches/wounds without a bite→ any contact→ prophylaxis

51
Q

How can rabies be transmitted

A

Bite: injection of saliva containing virus
Contact: sufficient to pose a risk
Aerosol transmission: has been documented→ bat caves

52
Q

Rabies incubation

A

Highly variable incubation period depends on distance of inoculation site from CNS: 2-16 weeks→ years

53
Q

Rabies prodrome phase

A

mild fever, pharyngitis, headache, coryza, abnormal pain/burning at site of inoculation, increased sensory sensitivity

54
Q

Rabies excitatory phase (furious phase in dogs)

A

anxiety, apprehension, hydrophobia in humans→ +/- death

55
Q

Rabies paralytic phase (dumb phase in dogs)

A

coma, hypotension, death

56
Q

Rabies diagnosis

A

History of bite/contact
Skunk, fox, raccoon or bat exposure→ prophylaxis

All animals considered rabid until proven otherwise by lab tests
→ kill and examine wild animals/stray pets→ Direct Fluorescent Antibody test (DFA) → viral inclusions: Negri body

→ quarantine healthy owned dogs and cats
→ rodents and rabbits rarely infected

57
Q

Negri body

A

viral inclusion of rabies seen on direct fluorescent antibody test

58
Q

Milwaukee protocol

A

2 cases of antiviral intervention success in cases of clinically overt rabies

59
Q

Usually clinical overt rabies

A

can’t be treated

60
Q

After exposure to rabies

A

Post-exposure vaccination (prophylaxis)

Unit 2 Micobio (9 decks)

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