Mumps and Childhood Exanthems Flashcards
The classic childhood exanthems
Measles, rubella, roseola, fifth disease, chickenpox
What type of virus is mumps and what is its structure?
Paramyxovirus. (-)-single stranded RNA with envelope
Symptoms and complications of mumps
Fever, swollen parotid gland(s), meningitis (10 percent), encephalitis (rare), hearing loss, orchitis of testes (15 percent of men)
What age group gets the highest frequency of infection with mumps?
Ages 5-15
For whom is immunotherapy with mumps hyperimmune globulin or gamma globulin recommended?
No one anymore. Currently no treatment available for mumps
What type of virus is measles and what is its structure?
Paramyxovirus, it is (-)-single stranded RNA
Prodromal symptoms of measles
Fever plus the 3 Cs (cough, coryza, and conjuctivitis) (coryza means head cold)
What are Kopliks spots and what disease are they associated with?
Grains-of-Salt type spots on red mucous membranes associated with measles
What is a common complication of measles and why?
Bacterial superinfection, because measles infects T and B cells, monocytes, and PMNs, weakening the immune system
What is the point of entry to the body for mumps and measles?
The respiratory tract (from there mumps goes to salivary glands and replicates, measles replicates in respiratory mucosal epithelium)
Bacterial superinfection is a common complication of measles. What is another significant complication?
Acute thrombocytopenic purpura occuring during the acute phase. Causes bleeding episodes with abdominal pain. Also viral encephalitis and subacute sclerosing panencephalitis (SSPE)
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)?
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.
Which is more common in the US today, mumps or measles?
Mumps is far more common (few US measles cases, and most of those are imported)
What type of virus is Rubella (german measles) and what is its structure?
Togavirus, enveloped single stranded RNA virus
What is the most serious form of rubella infection?
Congenital rubella infection (highest risk during first trimester, causes malformation in most early cases)
What has to happen for a congenital rubella infection to occur?
The mother has to be experiencing a primary rubella infection and has to enter her viremic stage of disease
What virus causes fifth disease and what is another name for the disease?
Pravovirus B19. Also called Erythema infectiosum
What is aplastic crisis and what viral infection can cause it?
Acute, severe anemia caused by parvovirus B19 (fifth disease) in pts with underlying RBC problems (sickle cell, thalassemia, AIDS, etc)
What is the most severe form of Parvovirus B19 infection?
Congenital infection. Can lead to hydrops fetalis if happens before 20 weeks
Which childhood exanthem shows a biphasic pattern?
Parvovirus B19
What causes roseola infantum (aka exanthem subitum)?
Roseola is caused by Herpes virus type 6 (also called sixth disease)
Which childhood exanthem has multiple types, what are the types, and what are the differences?
Roseola has type A and type B. A associated with adults, B with children
Which viral exanthem is associated with enhanced HIV-1 damage to the immune system?
Roseola type A (HHV6A)
Incubation and period of communicability for mumps
Incubation is 12-29 days, Period of communicability is 7 days before symptoms to 9 days after symptom onset
Laboratory diagnosis for mumps
Culture or PCR from saliva, pharynx, urine (positive for longest time), or CSF. Or acute and convalescent serology (easiest)
MMR is given to children over what age and how many doses are given?
Over one year, two doses
Incubation and symptoms in rubella
14 to 21 days. Fever, upper respiratory symptoms, lymphadenopathy, rash
Complications of rubella in adults
Transient arthralgia, transient arthritis (esp women), encephalitis, most infections uneventful
Which childhood exanthems do not have immunizations?
Parvovirus B19 (fifth disease) and Roseola (sixth disease)
What test is done to detect Parvovirus B19?
PCR, also use serodiagnosis
