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Parasitology/Virology > Measles, Mumps, Rubella > Flashcards

Measles, Mumps, Rubella Flashcards

1
Q

What is the structure of the paramyxoviruses (measles, mumps)?

A

Single stranded RNA in a helical nucleocapsid
Surrounded by lipid bilayer (wimpy) envelope
Envelope studded with virus encoded glycoproteins

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2
Q

How is measles spread?

A

Respiratory droplets

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3
Q

What is the pathogenesis of measles?

A

Infects respiratory epithelial cells of susceptible hosts
Incubates (virus replicates) and spreads to lymph nodes
Primary viremia infects respiratory epithelium and T cells

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4
Q

How long is the incubation period of measles?

A

10 days (until fever, rash appears day 14)

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5
Q

What are the first clinical manifestations of a measles infection?

A

3 C’s: Cough, coryza (runny nose), and conjunctivitis

Fever

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6
Q

What clinical manifestations of measles infection appear later on?

A

Koplik spots on buccal mucosa

Rash appears 4 days after fever

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7
Q

What are the characteristics of a measles rash?

A

Erythematous, maculopapular, coalesces to become confluent

Begins at hairline and spreads downwards

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8
Q

What makes measles such a deadly illness?

A

Causes transient but profound immunosuppression, making hosts susceptible to secondary infections

Also causes encephalitis
(sub acute scleroising panencephalitis can appear years later)

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9
Q

What is the most common cause of death in someone with a measles infection?

A

Pneumonia

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10
Q

What increases the severity of the measles infection?

A 
Malnutrition
Immunodeficiencies (HIV)
Vitamin A deficiency
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11
Q

How is measles diagnosed?

A

Clinical
Serology (IgM, paired acute-convalescent IgG)
Viral culture (difficult, can tell you if strains are related)
PCR

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12
Q

When is the measles vaccine given?

A

Given combined with mumps and rubella as MMR+/-V
Two doses given after 1 yo
(in endemic countries, vaccine given once at 9 mo)

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13
Q

What is the pathogenesis of mumps?

A

Infection in upper respiratory tract epithelium
Spreads to local lymph nodes
Viremia infects various sites (salivary glands, cochlea, seminiferous tubules)
CMI controls infection but also causes most of symptoms

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14
Q

How is mumps transmitted?

A

Respiratory droplets

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15
Q

When is someone with measles most infectious?

A

Before the rash appears (1-14 days after exposure)

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16
Q

When is someone with mumps most infectious?

A

2 days before salivary swelling to 5 days afterwards

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17
Q

What are clinical features of mumps?

A

1/3 asymptomatic
Characterized by swelling of salivary glands, particularly parotid
Can get swelling of other glandular tissue (testes)

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18
Q

What are complications of mumps infection?

A

Encephalitis
Deafness
Infertility

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19
Q

How is mumps diagnosed?

A

Clinical
Serology: IgM, IgG
Culture (saliva, CSF)
PCR (Can be positive after vaccine)

20
Q

What family and genus is Rubella in?

A

Togavirus family, Rubivirus genus (only member)

21
Q

What is the structure of Rubella?

A

Single stranded RNA
Lipid envelope (wimpy)
Glycoprotein spikes on surface

22
Q

How is Rubella spread?

A

Respiratory droplets

Vertical transmission

23
Q

What is the pathogenesis of Rubella?

A

NOT cytolytic
Infects upper respiratory tract
Spreads to local lymph nodes
Antibody develops and CMI eliminates infection

24
Q

How long is the incubation period of mumps?

A

2-3 weeks

25
Q

How long is the incubation period of rubella?

A

2-3 weeks

26
Q

When is someone with rubella most infectious?

A

Prodrome period (before symptoms) until 2 weeks after rash

27
Q

What are clinical symptoms of post-natally acquired Rubella?

A

Rash
Cervical lymphadenopathy
Arthritis

28
Q

The symptoms of Rubella are mild, so why do we vaccinate?

A

Congenital rubella has more serious effects

29
Q

What are clinical symptoms of congenital Rubella syndrome?

A

Triad of: Cataracts, Heart disease, Deafness

Also: hepatosplenomegaly, “blueberry muffin rash”, mental retardation

30
Q

How is Rubella diagnosed?

A

Clinical
Serology (IgM, IgG)
PCR
Culture (difficult)

31
Q

What is the structure of Parvovirus B19?

A

Very small
Non-enveloped (sturdy), icosahedral capsid
One linear, single stranded DNA

32
Q

What is the pathogenesis of Parvovirus?

A

Replicates in respiratory tract
Spreads by viremia to bone marrow where it replicates in and kills RBC precursors (anemia-causing)
Immune response dictates second phase (rash, arthritis)

33
Q

How is Parvovirus transmitted?

A

Respiratory droplets, blood products, vertical transmission

34
Q

When is someone with Parvovirus most infectious?

A

Until rash appears

35
Q

How long is the incubation period of Parvovirus?

A

4-14 days (rash appears 7-10 days later)

36
Q

What is the appearance of the Parvovirus rash?

A

Slapped cheek

37
Q

How does Rubella rash differ from Measles rash?

A

Rubella goes head to toe like measles, but fades as it progresses (unlike measles)

38
Q

What are clinical symptoms of Parvovirus?

A

Asymptomatic in 75%

Others show fever, distinctive rash days after fever, arthritis

39
Q

What are complicatoins of Parvovirus infection?

A

Anemia (transient aplastic crisis in those with hemoglobinopathy like sickle cell)
Fetal hydrops if mother infected in first half of pregnancy
Myocarditis

40
Q

How is Parvovirus diagnosed?

A

Clinical
Serology: IgM, IgG
PCR (blood or amniotic fluid)

41
Q

Which infections from this lecture do you not want if pregnant?

A

Parvovirus

Rubella

42
Q

Which infections from this lecture do you not want if you have sickle cell?

A

Parvovirus

43
Q

Which of these infections have secondary bacterial infectious as the leading cause of death?

A

Measles

44
Q

Which of these infections have rash at the same time as fever?

A

Rubella

45
Q

Which of these infections have rash after fever?

A

Parvovirus

Measles

46
Q

Which of these infections was once a leading cause of deafness?

A

Mumps

Parasitology/Virology (19 decks)

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