Parvovirus Flashcards

1
Q

Parvovirus -
meaning
enveloped or not
inactivated by

A

Small

non enveloped

resistant to most- except formalin, beta propionolactone, gamma irradiation, oxidizing agents

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2
Q

parvoviridae

subfamily
genera
species

A

parvovirinae (in vertebrates), densovirinae (in invertebrates)

5- TED BP
Tetraparvovirus (Parv4)
Erythroparvovirus (Parvo B19)
Dependovirus (Adnoassociated virus)
Bocaparvovirus (bocavirus)
Protoparvovirus (cuta, Bufa, Tusa)

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3
Q

Parv4

seroprevalence
clinical association
genotypes

A

0-25%
no clinical association
3 genotypes

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4
Q

Adnoassociated virus

why named so
how many tyoes
clinical association
use and why

A

require helper viruses (herpes or adeno) for replication
9
none
gene therapy vectors(no pathogenecity and can infect both replicating and non replicating cells)

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5
Q

bocavirus

seroprevalence (india)
types
causes what
how to diagnose

A

2-20% (2.5%)
1-4
1- URTI and LRTI in children
2-4 GI in children and adults
high titre viral load 10^4 in respiratory secretions/ dna in serum/ igm/ rising igg

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6
Q

Bufa virus- association

A

diarrhoea

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7
Q

Parvo B19- named so because
clinical causes

A

during evaluations of assays for hepatitis B surface antigen using panels of serum samples. Sample 19 in panel B (hence B19) gave an anomalous result

normal children, erythema infectiosum (EI),

normal adult, acute symmetrical polyarthropathy,

In persons with underlying hemolytic disorders or increased erythropoiesis, or both, transient aplastic crisis (TAC).

In the immunocompromised host, pure red cell aplasia (PRCA) and chronic anemia,

fetus <20 weeks, fetal death in utero, hydrops fetalis, or, rarely, the development of congenital anemia.

others: encephalitis, myocarditis, brachial neuropathy, glomerulonephritis

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8
Q

Parvovirus - genome products

A

Non structural proteins
NS
* DNA binding
* Adenosine triphosphatase activity
* Guanosine triphosphatase activity
* Inducer of apoptosis
* Critical for viral replication

11-KDa (Present in cytoplasm)- required for producing infectious virus

7.5-KDa (Function not known)

Structural proteins:
VP1 Minor (5% of capsid) – but larger in size: neutralising ab
VP1u (unique region):
* virion binding and internalization
* PLA2 activity

VP2 Major, self assembles into virus-like particles (VLPs)- first antibody to be produced

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9
Q

Parvovirus B19- genotypes and where; serotypes

A

3- 1 and 2 worldwide; 3 in ghana, brazil, europe and india

1 serotype- no reinfection

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10
Q

Parvovirus B19-

affects which cells

A

blood gorup P antigen - globoside

erythroid progenitor and erythroblasts
megakaryocytes
endothelial cells - vasculitits, transplacental
myocardial cells

NS expression causes apoptosis

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11
Q

co recptors for parvo b 19

A

alpha 5 beta 1 integrin (fibronectin)

Ku 80

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12
Q

seroprevalence in children by 15 yrs and older adults worldwide and india

A

50, 80
10, 50

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13
Q

transmission of parvo b19

routes of transmission
secondary attack rate

A

increased transmission in late winter, spring , summer

rates of infection increases every 3-4 years

respiratory secretions
close contact
blood transfusions (resist inactivation)
vertical

50%

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14
Q

erythema infectiosum- sympotms

natural course

A

IP 5-6 days :
symptoms: biphasic- 1st fever, malaise, mild gi illness, headache - peak at 8-9 days

coincides with viremia (>10^9 in peak- after this reduces to 10^5-6 persists for 4 months in serrum, but longer in tissues- liver, heart, synovium, bone marrow)

coicides with reticulocyte fall

Ig M in 10-12 days down in 2-3 months
IgG in 14 days and persists for life

As IgG increases second phase of symptoms - rash and arthropathy

Rash- slapped cheek- 1st stage
2nd: maculopapular on trunk and limbs, as it disappears - lacy appearance
3rd- persisting rash for weeks; maybe associated with pruritis, vesiculopustular rash, papulopetechial gloce and sock syndrome

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15
Q

arthropathy by parvo b19- symptoms and dd

A

symmetrical, small joints, lasts for 1-3 weeks, can persist

can also cause transient RF increase

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16
Q

TAC - predisposing, symptoms, other lineage differences

A

hemolytic stress- hemorrhage, iron def anemia, other types of anemia too

dyspnoea, lassitude and confusion, heart failure, severe bone marrow necrosis, CNS complications

neutropenia, thrombocytopenia, ITP HSP

17
Q

coomunity azquired aplastic crisis mcc

A

parvo B19

18
Q

Fetal infection by B19

A

Gestational Age Risk of adverse fetal outcome
(Weeks)
9-20 wks.
* Fetal loss - 9 %

* Hydrops fetalis- 3-11% (40-50% mortality without therapy)
       (non-immune) > 20 wks.	< 1 % 

Gestational Age Risk of intrauterine (transplacental) infection
(Weeks)
< 4 wks. 0 %
5-16 wks. 15 %
> 16 wks. 25-70 %
(Increases with gestation)

B19 cause 10-15% o fall nonimmune hydrops fetalis

19
Q

EI and polyarthropathy diagnosis, treatment and hic

A

IgM or IgG seroconversion

self limiting; NSAIDS

HIC- infective 2 weeks before

20
Q

TAC - diagnosis, treatment and hic

A

DNA PCR in whole blood

IgM on day 3 of symptoms or IgG seroconversion

blood transfusion

7 days after

21
Q

intrauterine infection - diagnosis, treatment

A

maternal- IgM/IgG seroconversion/ IgG avidity/ DNA levels

fetal- cord blood PCR, amniotic fluid PCR

may spontaneous resolve mostly; exchange transfusion if hydrops proven

21
Q

PRCA - diagnosis, treatment and hic

A

DNA PCR in whole blood

reduction of immunosuppression
cidofovir
ivig 0.4g/kg/day for 5 days- followup by DNA, reticulocyte count and Hb level; if relapse in 6 months, maintenance ivig is once a month

till in hospital

22
Q

Bone marrow finding

A

Reticulocyte reduction
Loss of erythroid progenitors and erythroblasts
Lantern cells- giant normoblasts - cytoplasmic vacuolations, immature chromatin, eosinophilic inclusion bodies in nucleus- shows apoptosis