Mumps and Childhood Exanthems

Question 1

The classic childhood exanthems

Answer 1

Measles, rubella, roseola, fifth disease, chickenpox

Question 2

What type of virus is mumps and what is its structure?

Answer 2

Paramyxovirus. (-)-single stranded RNA with envelope

Question 3

Symptoms and complications of mumps

Answer 3

Fever, swollen parotid gland(s), meningitis (10 percent), encephalitis (rare), hearing loss, orchitis of testes (15 percent of men)

Question 4

What age group gets the highest frequency of infection with mumps?

Answer 4

Ages 5-15

Question 5

For whom is immunotherapy with mumps hyperimmune globulin or gamma globulin recommended?

Answer 5

No one anymore. Currently no treatment available for mumps

Question 6

What type of virus is measles and what is its structure?

Answer 6

Paramyxovirus, it is (-)-single stranded RNA

Question 7

Prodromal symptoms of measles

Answer 7

Fever plus the 3 Cs (cough, coryza, and conjuctivitis) (coryza means head cold)

Question 8

What are Kopliks spots and what disease are they associated with?

Answer 8

Grains-of-Salt type spots on red mucous membranes associated with measles

Question 9

What is a common complication of measles and why?

Answer 9

Bacterial superinfection, because measles infects T and B cells, monocytes, and PMNs, weakening the immune system

Question 10

What is the point of entry to the body for mumps and measles?

Answer 10

The respiratory tract (from there mumps goes to salivary glands and replicates, measles replicates in respiratory mucosal epithelium)

Question 11

Bacterial superinfection is a common complication of measles. What is another significant complication?

Answer 11

Acute thrombocytopenic purpura occuring during the acute phase. Causes bleeding episodes with abdominal pain. Also viral encephalitis and subacute sclerosing panencephalitis (SSPE)

Question 12

SSPE is a rare but serious complication of a particular viral infection. When does it occur and what causes it (name virus and give details)?

Answer 12

Subacute sclerosing panencephalitis (SSPE) begins 2-10 years after original measles infection. Results from measles virus missing M-protein (needed for assembly) causing accumulation of viral particles.

Question 13

Which is more common in the US today, mumps or measles?

Answer 13

Mumps is far more common (few US measles cases, and most of those are imported)

Question 14

What type of virus is Rubella (german measles) and what is its structure?

Answer 14

Togavirus, enveloped single stranded RNA virus

Question 15

What is the most serious form of rubella infection?

Answer 15

Congenital rubella infection (highest risk during first trimester, causes malformation in most early cases)

Question 16

What has to happen for a congenital rubella infection to occur?

Answer 16

The mother has to be experiencing a primary rubella infection and has to enter her viremic stage of disease

Question 17

What virus causes fifth disease and what is another name for the disease?

Answer 17

Pravovirus B19. Also called Erythema infectiosum

Question 18

What is aplastic crisis and what viral infection can cause it?

Answer 18

Acute, severe anemia caused by parvovirus B19 (fifth disease) in pts with underlying RBC problems (sickle cell, thalassemia, AIDS, etc)

Question 19

What is the most severe form of Parvovirus B19 infection?

Answer 19

Congenital infection. Can lead to hydrops fetalis if happens before 20 weeks

Question 20

Which childhood exanthem shows a biphasic pattern?

Answer 20

Parvovirus B19

Question 21

What causes roseola infantum (aka exanthem subitum)?

Answer 21

Roseola is caused by Herpes virus type 6 (also called sixth disease)

Question 22

Which childhood exanthem has multiple types, what are the types, and what are the differences?

Answer 22

Roseola has type A and type B. A associated with adults, B with children

Question 23

Which viral exanthem is associated with enhanced HIV-1 damage to the immune system?

Answer 23

Roseola type A (HHV6A)

Question 24

Incubation and period of communicability for mumps

Answer 24

Incubation is 12-29 days, Period of communicability is 7 days before symptoms to 9 days after symptom onset

Question 25

Laboratory diagnosis for mumps

Answer 25

Culture or PCR from saliva, pharynx, urine (positive for longest time), or CSF. Or acute and convalescent serology (easiest)

Question 26

MMR is given to children over what age and how many doses are given?

Answer 26

Over one year, two doses

Question 27

Incubation and symptoms in rubella

Answer 27

14 to 21 days. Fever, upper respiratory symptoms, lymphadenopathy, rash

Question 28

Complications of rubella in adults

Answer 28

Transient arthralgia, transient arthritis (esp women), encephalitis, most infections uneventful

Question 29

Which childhood exanthems do not have immunizations?

Answer 29

Parvovirus B19 (fifth disease) and Roseola (sixth disease)

Question 30

What test is done to detect Parvovirus B19?

Answer 30

PCR, also use serodiagnosis