Measles, mumps, rubella Flashcards
1
Q
Mumps Virus
- acute or chronic?
- Pathogenesis
- What organs can be affected?
- Transmission
A
- acute
- Inoculation of respiratory tract –> local replication –> Viremia –> systemic infection
- Parotid gland, Testes, Ovaries, peripheral nerves, eye, inner ear, central nervous system, pancreas (assoc w/ onset of juvenile diabetes)
- Respiratory Droplets
2
Q
Where does the virus infect the parotid gland and what happens?
A
ductal epithelial cells
local inflammation causes marked swelling (may be uni/bilateral)
3
Q
- When are you infectious with mumps?
2. What is a notable consequence of infection? How common?
A
- Can have virus in mouth/urine before symptoms begin
2. small subset of pts get meningoencephalitis and virus present in CSF
4
Q
Mumps Pathogenesis (3) 4. What is essential for control of infection?
A
- Infects epithelial cells of respiratory tract
- spreads systemically by viremia
- systemic infection, especially of parotid gland, testes, and CNS
- Cell-mediated immunity, responsible for some symptoms; Ab not sufficient due to its ability to spread cell to cell
5
Q
Mumps
- Clinical Diagnosis
- Lab Diagnosis
A
- acute onset of unilateral or bilateral swelling of parotid or salivary gland lasting >2 days w/o other apparent cause
- isolation of virus; significant increase in IgG Ab level between acute and convalescent samples; positive serologic test for mumps IgM antibody
6
Q
Mumps Vaccine
- Composition
- Duration of Immunity
- Dose
A
- Live-attenuated virus
- Lifelong
- 1; should be administered with MMR
7
Q
Measles
- Symptoms (4)
- Target Organs
- 3 C’s and a K
- Major complication
- Transmission
A
- Mild Respiratory infection; Spread to cervical lymph nodes; Viremia, Fever and Rash (maculopapular)
- Skin, CNS (rarely)
- Coryza, cough, conjunctivits, Kopli’s spots
- encephalitis
- respiratory droplets (sneezing, coughing); is extremely infectious
8
Q
Measles
- Kopli’s spots
- When does cough occur?
A
- transient spots on skin or mucous membranes that look like large grains of salt
- cough precedes the rash
9
Q
Measle vaccine
- What is a common source of US outbreaks?
- How is it commonly administered?
- Type of vaccine?
A
- adopted children brought into the US from orphanages
- with the MMR,
- live attenuated vaccine
10
Q
Subacute Sclerosing Panencephalitis
- What is it?
- Mortality rate?
- When does it occur?
- What increases risk of SSPE?
A
- scarring and demyelination of many areas of the brain, causing mental deterioration; occurs mostly in children following natural measles infection
- almost 100%
- mostly in children, follows natural measles infection and a long incubation period (months to years)
- infection in young child
11
Q
Mumps and Measles
- family of viruses?
- genome
- why are they vaccinated?
A
- Paramyxoviridae
- negative strand RNA
- viremia causes an intense natural immune response
12
Q
Rubella (German Measles)
- Symptoms
- genome/ envelope/ family
- When is pt infectious?
- Lab Dx
- Why is rubella a problem?
A
- URTI, maculopapular rash; mild disease
- strand RNA/ has envelope/ togavirus
- before and after rash appears
- Isolation from clinical specimen; rise in IgG by any standard serologic assay; positive serologic test for rubella IgM
- congenital Rubella syndrome
13
Q
Rubella
- Transmission
- number of serotypes
A
- aerosol (cough); highly contagious
2. 1
14
Q
Congenital Rubella Syndrome
- Who does it infect?
- When?
- Manifestations (2)
A
- if it infects pregnant women, can infect fetus –> CRS
- usually in first trimester
- Severe- Spontaneous Abortions and Stillbirths
Mild, Chronic- Congenital Rubella Syndrome
15
Q
Congenital Rubella Syndrome
- Symptoms
- What role does vaccine play?
A
- Deafness, Cataracts, heart defects, microcephaly, mental retardation, bone alterations, liver and spleen damage
- high coverage rates with MMR = low incidence of CRS
