L21- BW (viral skin) Flashcards
what is zostavax
shingles vaccine that is live attenuated, higher potency than Varivax
what are the prerequisites for shingles
a prior case of chickenpox or vaccination against chickenpox
VZV vaccines protect against
chickenpox, NOT shingles
why is it recommended to get 2 doses of Vavirax
breakthrough cases (mild chickenpox after exposure) is well documented
names of the VZV vaccines and what type
Vavirax and MMRV, live attenuated
where does VZV live in latency
in neural tissues until a shingles recrudescence of prior VZV chickenpox
slapped cheek with circumoral sparing manifestation
parovirus B19 aka fifth disease aka erythema infectiosum
VZV prodrome
fever, malaise, HA, myalgia, anorexia (only in older kids and adults)
what does zoster refer to
a belt or stripe
Measles presentation has 3 Cs
Coryza, Cough, Conjunctivitis
what time of year does parovirus B19 occur
in epidemics in late winter and spring
what is the rule of thumb for HSV latency
the probability of recrudescence is greater in individuals with larger and more extensive initial outbreaks
shingles vaccines
zostavax and shingrix
how do adult pts with parovirus B19 present
arthritis or arthralgias without preceding or concurrent sxs
what is shingrix
shingles vaccine that is a nonviable adjuvanted virus subunit preparation, superior protection
who is zostavax for
NOT people without a hx of prior chickenpox infection (such as vaccinated)
MMR is not appropriate for what population and why
preggos, those who plan to become pregnant w/in 3 months of vacc, and immunosuppressed- because its live attenuated
painful lesions with a unilateral dermatomal distribution (sharp limits) that do not cross the center line
shingles
how can you prophylactically prevent measles in unvaccinated or immunocompromised pts and for how long after exposure
immune globulin (BayGram) up to 6 days after exposure
what populations experience the prodrome with VZV
older children and adults, younger children don’t have it
3 Cs
Measles
what two unique HSV properties influence disease
(1) capacity to invade and replicate in CNS, and (2) ability to establish latent disease
what fraction of HSV sheddings are asymptomatic
2/3
recrudescence
quasi stable state of latency that is subject to reactivation (seen in HSV and VZV)
how many doses of shingrix
2
who is shingrix for
good for people who have been previously vaccinated with zostavax
where does HSV live during latency
it is retrograde transported through sensory neurons and ultimately infects the dorsal root ganglia
HSV phases
(1) primary (maybe asymptomatic) infection that resolves (2) quasi stable state of latency subject to reactivation (recrudescence)
what is critical to the outcome of critical rubella syndrome
the timing of infection- early in pregnancy is worst
PRURITIC lesions with neuralgia, fever, malaise, HA
VZV
when was measles declared eradicated in the US
2000
what skin virus is very prevalent and totally unrecognized without cx
HHV- 6 (humans herpes virus-6)
VZV causes
BOTH chickenpox and shingles
MMR has how many doses
2 plus a BOOSTER third dose
HSV treatments are ___ but ____
highly effective but not curative
what can be used for high risk persons exposed to VZV
VariZIG human immunoglobulin
VZV is a potential ___
TERATOGEN when infections occur in utero
when does most HSV transmission occur
during asymptomatic shedding (which is frequent) or from persons who never knew they were infected
how much reduction of measles in the US due to vaccine
99%
principle problem linked to rubella
congenital rubella syndrome
what tx is NOT recommended with VZV and why
ASA- risk of Reyes syndrome
HSV is spread by
direct contact with vesicular fluid, saliva, and secretions, asymptomatic shedding
when was the largest US measles outbreaks since it was declared eradicated
2014-2015
measles is controlled by vaccination in the West but
still present in the remainder of the world
what lead to the principal problem linked to rubella
children escaping infection (congenital rubella syndrome is principal problem)
Kopliks spots
Measles- large spots on buccal mucosa
congenital rubella syndrome
when infection occurs in women during the first trimester of pregnancy, leading to a SUBSTANTIAL RISK TO FETUS
how long is HSV latency
lifelong
