MMR Flashcards
Examples of paramyxovirus?
Measles & Mumps
Characteristics of paramyxoviruses?
Enveloped, Spikes, ss RNA
Incubation period of measles virus?
10-14d
When do patients get measles?
By 5 years old.
How is measles spread?
Aerosol spread – very contagious
Where can the measles virus exist?
Viraemia, Respiratory Epithelium & Skin
Progression of the measles virus?
D1-D7: Fever, Conjunctivitis, Rhinorrhoae, Cough
D2-D6: Koplik’s Spots around Parotid Duct orifices (herald onset)
D4-D9: Maculopapular Rash from face to whole body (flat & palpable, geographic pattern)
Complications of Measles?
- Mucosal Infections
- Conjunctivitis
- Otitis Media - Respiratory
- Bronchopneumonia - GI
- diarrhoae
- secondary bacterial infection - Encephalitis
- Sub-Acute Sclerosing Panencephaltis
- persistent latent infection of neurons
- myoclonic seizures, intellectual deteroriation
- “suppresion-burst” EEG pattern (low voltage interuptted by periodic high voltage complexes)
- cytoplasmic inclusions in neuronal cells
3 ways measles can be diagnosed?
- Tissue Culture
- isolated from pharynx, conjuctiva
- infected monkey kidney cells show multinucleated giant cells - RT-PCR
- Serology - IgM for recent infection; TgG for retrospective
Prevention of measles?
MMR vaccine at age 12m and 12-18m (earlier in poorer communities)
Who should NOT receive the measles vaccine? What should they receive?
Malnourished, Immunocompromised, pregnant. Give passive immunisation with IVIG
When do people get infected by mumps?
5-15 yo
What is the incubation period for mumps?
2-3wks
Clinical presentation of mumps?
Fever
Malaise
Salivary Gland Enlargement (parotid)
Complications of mumps?
- Aseptic Meningitis
- Orchitis (pain and swelling)
- usually unilateral; if bilateral can lead to subfertility - Pancreatitis
- Myocarditis, Nephritis, Oophritis, Thyroiditis, Demyelinating encephalitis, arthrtis
methods for diagnosing mumps?
Samples from saliva, throat, urine, CSF
RT-PCR
Tissue culture using cell lines on hen’s eggs – cytopathic effect (rounding of cells, multinucleated syncytial formation, eosinophilic inclusions
Serology - IgM + IgG
Prevention of mumps?
Live attenuated vaccine
What virus is a togavirus?
Rubella
What are characteristics of togaviruses?
- Icosahedral symmetry
- Enveloped
- RNA
- 1 serotype
What is the incubation for rubella?
2-3weeks
Clinical presentation of rubella?
Malaise, Headache, Fever
Conjuctivitis, Cough, Lymphadenopathy (Suboccipital, Posterior Auricular, Cervical)
Rose spots (Forscheimer’s spots) herald onset of skin rash
Rubella Rash (small maculopapular lesions from face to trunk & extremities (3d) - can coagulase to form erythemous sheet (geographic pattern)
- d1: upper body and heart
- d3: UL + LL
Complications of Rubella?
- Arthralgia, Arthritis
- Encephalitis
- Purpura
- Teratogenic (esp in first trimester)
- still born
- ocular, ear, CNS defects
- CVS/Respi malformations - T1DM
- Hepatosplenomegaly
- Thrombocytopenia
- Bone (metaphyseal osteitis)
- Hemorhagic Rash
How to diagnose rubella?
Tissue culture
RT-PCR
Serology - IgM, Antibody Titre, TORCHES
Management and Prevention of Rubella?
Live attenuated vaccine (no conveiving within 3m; other side effects are fever, rash, arthralgia, arthritis, lymphadenopathy)
Quarentine, Specific Ig, screen close contacts, screen pregnant mothers for rubella antibodies
Rubella RO?
High.»_space;10
