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Infection > Lecture 11.2: Emerging and Re-emerging Infectious Disease > Flashcards

Lecture 11.2: Emerging and Re-emerging Infectious Disease Flashcards

1
Q

National Institute of Allergy and Infectious Disease (NIAID) Classification (3)

A
  • Group I – pathogens that have been newly recognised in the last 20 years
  • Group II – Reemerging pathogens
  • Group III – Agents with bioterrorism potential, subdivided
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2
Q

What is Ebola?

A

An infectious and frequently fatal disease marked by fever and severe internal bleeding, spread through contact with infected body fluids by a filovirus ( Ebola virus ), whose normal host species is unknown

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3
Q

How is Ebola Transmitted?

A

Human-to-human transmission occurs via skin and mucous membrane contact
with body fluids (rarely with a primate)

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4
Q

When is someone with Ebola infectious?

A

• Humans are not infectious until they develop symptoms
• Symptoms and signs persist in surviving patients for as long as it takes to
develop an effective immune response

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5
Q

Pathway of Ebola Infection

A
  • Incubation period of 2 to 20 days
  • Day 7-9, headache, myalgia, fever, fatigue
  • Day 10, sudden high fever, vomiting blood, passive behaviour
  • Day 11, bruising, brain damage, bleeding from nose, mouth, eyes, anus
  • Day 12, loss of consciousness, seizures, massive internal bleeding, death
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6
Q

Can you recover from Ebola?

A

• During the 2nd week of symptoms, either defervescence occurs and patients
begin recovery, or patients develop fatal multiple organ failure and die
• Recovery is prolonged and may be complicated by recurrent hepatitis,
transverse myelitis, and orchitis
• The case fatality rate ranges from 25 to 90%

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7
Q

Can Ebola be a recurring infection?

A

• Ebola virus can persist in the central nervous system and ultimately cause a
relapse
• Ebola virus may persist in certain immune-privileged sites (eye, brain, testes)
• The virus may re-emerge from these sites and cause late sequelae or relapse • Sexual transmission from survivors to susceptible individuals is suspected

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8
Q

How many strains of Ebola are there?

A
  • There are 5 strains of the Ebola Virus

* The deadliest is the Zaire Ebola strain

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9
Q

What are the chances of surviving Ebola?

A
  • 8 out of 10 die

* So 2/10 chance of survival

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10
Q

What Group is Ebola classed in?

A

Group III

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11
Q

What is TB?

A

• Caused by a type of bacterium called Mycobacterium tuberculosis
• Mainly affects the lungs, but it can affect any part of the body, including the
abdomen, glands, bones and nervous system

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12
Q

What Group is TB classed in?

A

Group III

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13
Q

How many people have died of TB in the last 200 years?

A

• TB has claimed the lives of more than one billion people
• More deaths than from malaria, influenza, smallpox, HIV/AIDS, cholera, and
plague combined
• Although TB treatment exists, drug resistance is a continued threat

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14
Q

Microscopic Features of TB

A
  • Rod-shaped bacillus
  • Acid-fast stain
  • Nonspore forming
  • Produces mycolic acid
  • Makes it difficult to Gram stain
  • Protects the pathogen from antibiotic therapy and host defences
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15
Q

What are the 3 types of Tuberculosis?

A
  • Primary Tuberculosis – initial case of tuberculosis disease
  • Secondary Tuberculosis – reestablished tuberculosis
  • Disseminated Tuberculosis – tuberculosis involving multiple systems
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16
Q

What are the 3 Stages of Tuberculosis Infection?

A
  • Primary Infection (not transmissible)
  • Latent Infection (not transmissible)
  • Active Infection (transmissible)
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17
Q

How is TB Treated?

A 
Today, four drugs are used to treat TB disease: 
• Isoniazid (1951)
• Pyrazinamide (1952)
• Ethambutol (1961)
• Rifampin (1966)

This 4-drug cocktail is still the most common treatment for drug-susceptible TB

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18
Q

Mechanism of TB Infection

A

• M. tuberculosis cell wall interferes with macrophage function and immune cells
activation
• Inhibits the formation of the phagolysosome
• This allows Mt to escape into the cytoplasm
• Here it increases in number & eventually spreads to the lymph nodes
• From here it enters the blood and is distributed throughout the body

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19
Q

What are Tubercles?

A

Tubercles are aggregates of enlarged macrophages filled with bacteria

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20
Q

Is there a TB vaccine?

A
  • Yes, the BCG Vaccination
  • Often given to infants & small children in countries where TB is more common
  • Protects against severe forms of TB in children
  • The TB vaccine is not widely used
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21
Q

What is Measles?

A
  • Paramyxovirus
  • Single stranded RNA
  • Enveloped virus (transmembrane hemagglutinin & glycoproteins)
  • Airborne transmission
  • Droplets expelled in coughing & sneezing
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22
Q

What Group is Measles in?

A

Group II

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23
Q

What are Signs and Symptoms of Measles?

A
  • Highly contagious infection of the respiratory system
  • Fever
  • Malaise
  • Cough
  • Coryza & conjunctivitis
  • Pathognomonic Koplik spots
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24
Q

What is the reason for most Measles related deaths? Examples?

A 
• Most measles-related deaths are caused by complications associated with the 
  disease
• Blindness
• Encephalitis
• Severe Diarrhoea 
• Dehydration
• Ear Infections
• Severe Respiratory Infections (e.g. pneumonia)
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25
Q

Which group of people are most susceptible to Measles related deaths?

A
  • Children below the age of 5

* Adults over the age of 50

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26
Q

Treatment for Measles (5)

A
  • No specific antiviral treatment exists for measles virus
  • Supportive care
  • Good Nutrition
  • Adequate Fluid Intake
  • Treatment of Dehydration
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27
Q

What is Mumps?

A

• Mumps is an acute, generalised viral infection characterised by bilateral parotid
swelling
• Member of the family Paramyxoviridae, is an enveloped particle containing a
non-segmented negative strand RNA molecule of 15,384 nucleotides

28
Q

What Group is Mumps in?

A

Group II

29
Q

How is Mumps Transmitted?

A

MuV is transmitted via the respiratory route by inhalation or oral contact with infected respiratory droplets or secretions

30
Q

Signs and Symptoms of Mumps (7)

A 
• Flu-like Symptoms 
• Fever
• Headache
• Malaise
• Myalgia 
• Anorexia
• Parotitis (swelling of the parotid glands) then develops in 95% of symptomatic 
  cases
• Orchitis 
• Meningitis/Encephalitis
31
Q

What is Monkeypox?

A

• Member of the Orthopoxvirus group
• Monkeypox virus is a species of double-stranded DNA virus which causes
monkeypox in humans and other animals
• Human disease occurs in Africa sporadically and in occasional epidemics

32
Q

Why has there been an increase in incidence of Monkeypox?

A

A recent 20-fold increase in incidence is thought to be due to the cessation of
smallpox vaccination

33
Q

Signs and Symptoms of Monkeypox

A
  • Skin lesions occur
  • Lymphadenopathy occurs in monkeypox but not in smallpox
  • Secondary bacterial infection of the skin and lungs may occur
34
Q

Treatment of Monkeypox

A

• The antiviral drugs have activity against monkeypox in vitro and in experimental
models.
• However, none of these drugs have been studied/used in endemic areas
• Past data from Africa suggests that the smallpox vaccine is at least 85%
effective in preventing monkeypox, because monkeypox virus is closely related
to the virus that causes smallpox

35
Q

What is Bioterrorism?

A

The intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops

36
Q

How can Bioterrorism be achieved/spread? (5)

A
  • Aerosol Sprays
  • Explosive Devices
  • Food
  • Water
  • Absorbed or Injected into Skin
37
Q

What are Category A Pathogens? What is their effect?

A

• Organisms/biological agents that pose the highest risk to national security and
public health
• Can be easily disseminated or transmitted from person to person
• Result in high mortality rates, have the potential for major public health impact
• Might cause public panic and social disruption
• Require special action for public health preparedness

38
Q

What are Category B Pathogens? What is their effect?

A

• 2nd highest priority organisms/biological agents
• Are moderately easy to disseminate
• Result in moderate morbidity rates and low mortality rates
• Require specific enhancements for diagnostic capacity and enhanced disease
surveillance

39
Q

What are Category C Pathogens? What is their effect?

A

• 3rd highest priority

Include emerging pathogens that could be engineered for mass dissemination in the future because of:
• Availability
• Ease of production and dissemination
• Potential for high morbidity and mortality rates and major health impact

40
Q

What is Plague/Yersinia?

A

• Plague is caused by the bacteria Yersinia pestis
• A zoonotic bacteria usually found in small mammals and their fleas.
• People infected with Y. pestis often develop symptoms after an incubation
period of 1-7 days

41
Q

What Group is Plague/Yersinia in?

A

Group III

42
Q

`What are the 3 Types of Plague/Yersinia?

A
  • Bubonic
  • Pneumonic
  • Septicemic
43
Q

What form of Plague is the most common?

A

Bubonic

44
Q

What is the incubation period of Bubonic Plague?

A

2-8 Days

45
Q

Signs and Symptoms of Bubonic Plague (5)

A
  • Fever
  • Headache
  • Chills
  • Weakness
  • One or more swollen, painful lymph nodes (called buboes)
46
Q

What is the Vector for Bubonic Plague?

A

Fleas

47
Q

What is the fatality rate for Bubonic Plague?

A

30-60%

48
Q

What is the fatality rate for Pneumonia Plague?

A

100% if untreated

49
Q

Treatment of Plague

A

Antibiotics

50
Q

Signs and Symptoms of Septicemic Plague (7)

A
  • Fever
  • Chills
  • Extreme Weakness
  • Abdominal Pain
  • Sock
  • Possibly bleeding into the skin and other organs
  • Skin & other tissues may turn black and die, especially on fingers, toes & nose
51
Q

How is Septicemic Plague Spread?

A
  • Septicemic plague can occur as the first symptom of plague
  • May develop from untreated bubonic plague
  • Result of bites of infected fleas or from handling an infected animal
52
Q

What is incubation period of Pneumonic Plague?

A

1-3 Days

53
Q

Signs and Symptoms of Pneumonic Plague (10)

A
  • Fever
  • Headache
  • Weakness
  • Rapidly developing pneumonia
  • Shortness of Breath
  • Chest Pain
  • Cough
  • Bloody or Watery Mucous
  • Respiratory Failure
  • Shock
54
Q

How is Pneumonic Plague Spread?

A

• Pneumonic plague is the most serious form of the disease
• Only form of plague that can be spread from person to person (by infectious
droplets)
• May develop from untreated bubonic or septicemic plague after the bacteria
spread to the lungs

55
Q

What is West Nile Virus?

A
  • Neurotropic
  • Arthropod-borne Flavivirus
  • Single-stranded positive-sense RNA genome
  • Causes West Nile Fever
  • Only severe in 1% cases
56
Q

What Group is West Nile Virus?

A

Group II

57
Q

How is West Nile Virus Spread?

A

• Maintained in Enzootic cycle between mosquitoes and birds
• Can also infect and cause disease in horses and humans, which serve as
incidental dead-end hosts

58
Q

Where is West Nile Virus Endemic?

A

Africa, Europe, the Middle East, and Asia

59
Q

Signs and Symptoms of West Nile Virus (9)

A

• Most (4 out of 5) patients with West Nile virus infection have no symptoms.
• Fever
• Headache
• Body Aches
• Joint Pain
• Vomiting
• Diarrhoea
• Rash
• About 1 in 150 patients develop severe central nervous system involvement
with encephalitis, meningitis, or flaccid paralysis

60
Q

What is Nipah Virus? (3)

A
  • Nipah virus, scientific name Nipah henipavirus
  • Bat-borne virus that causes Nipah virus infection in humans and other animals
  • Has a high mortality rate
61
Q

What Group is Nipah Virus in?

A

Group III

62
Q

How does Nipah Virus present clinically?

A
  • Asymptomatic Infection (subclinical)
  • Acute Respiratory Infection
  • Fatal Encephalitis
63
Q

What is the fatality rate of Nipah Virus?

A

40% to 75%

64
Q

How is Nipah Virus Spread? What is the Natural Host?

A
  • Humans from animals (such as bats or pigs)
  • Contaminated foods
  • Directly human-to-human.
  • Fruit bats of the Pteropodidae family are the natural host of Nipah virus
65
Q

What treatment is available for the Nipah Virus?

A
  • There is no treatment or vaccine available for either people or animals
  • The primary treatment for humans is supportive care

Infection (21 decks)

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