Picornaviruses Flashcards
Which Enterovirus(es) cause: Poliomyelitis?
Poliovirus, EV-71
Which Enterovirus(es) cause Meningitis/Encephalitis:
Coxsackie A&B; Echovirus
Which Enterovirus(es) cause: Myocarditis/Pericarditis
Coxsackie B
Which Enterovirus(es) cause:Pleurodynia
Coxsackie B
Which Enterovirus(es) cause:Hand Foot and Mouth dz
Coxsackie A, EV-71
Which Enterovirus(es) cause Herpangia:
Coxsackie A
Which Enterovirus(es) cause Respiratory Infections:
EV-68
Which Enterovirus(es) cause Acute Hemorrhagic Conjunctivitis:
EV-70, Coxsackie A
Which Enterovirus(es) cause Generalized infx of newborn:
Echo, Coxsackie B
what immune cells are important in fighting enterovirus infections
B cells
at what point in a picornavirus/enterovirus infx are neutralizing antibodies useful?
After spread from pharynx to intestinesthey invade the regional LNs. At this point the virus is usually cleared (i.e., the virus establishes minor viremia, but not major viremia)
What are the 4 main outcomes of poliovirus infections?
Asymptomatic infection (MC)
Abortive poliomyelitis (fever less than week)
Non-paralytic poliomyelitis (meningitis, no paralysis, full recovery)
Paralytic poliomyelitis
where does poliovirus replicate
motor neurons (lytic infection) of the anterior horn
How to differentiate between poliovirus and Guillane Barre
Guillane-Barre has sensory loss)
3 types of paralytic poliomyelitis
Spinal
Bulbar
combined
How does Spinal poliomyeltis present
flaccid paralysis, atrophy, Usually asymmetric in lower limbs, with sensory perception intact (vs Guillane-Barre)
How does bulbar poliomyelitis present?
paralysis of the pharyngeal and laryngeal muscles, facial muscles, and/or tongue.
paralysis of diaphragm and intercostal muscles requiring mechanical ventilation.
What is Post-Polio Syndrome and how does it present
§ Weakness in muscles that were affected and then recovered
§ Can affect muscles unaffected by the initial, acute polio attack
-Occurs many years later, usually (36 years)
2 polio vaccines, route of administration, and what type they are
Salk - IM shot, killed/inactivated
Sabin- Oral, live attenuated
what is one advantage and one drawback of the (OPV) Sabin vaccine?
- Secretion of vaccine virus could spread immunization to unvaccinated.
- can cause vaccine-associated paralytic poliomyelitis (VAPP).
What is only vaccine given in US
Salk (IVP)
What is the #1 cause of viral meningitis? (genus and 3 species)
1 cause = Enteroviruses: Coxsackievirus A and B, echovirus
What age group is most affected with viral meningitis
young kids
What enteroviruses cause encephalitis
the same ones that cause meningitis: Coxsackievirus A and B, echovirus
What occurs in WBC (composition and # of cells) in enterovirus meningitis?
Cell count = 10 to 500
-neutrophils predominate in first 1 to 2 days then shifts to leukocytes
What is best method to dx enterovirus meningits?
virus in CSF by nucleic acid amplification tests (NAAT) like RT-PCR
what pop is at risk of chronic meningoencephalitis caused by enteroviruses?
people (children) with B cell deficiencies: X-linked agammaglobulinemia, severe combined immunodeficiency syndrome
What is the main enterovirus that causes myocarditis/pericarditis?
Coxsackie B
How is coxsackie B myocarditis/pericarditis diagnosed? (3 ways)
- Viral RNA present in endomyocardial bx
- RT-PCR positive serum, stool, throat swab
- 4 fold increase in antibody titer over several week
What is the major sequelae of coxsackie B myocarditis/pericarditis?
dilated cardiomyopathy.
What viruses causes epidemic pleurodynia? by infecting what cells? outocme?
Coxsakievirus B infects skeletal muscle cells (intercostals)
complete recovery usually
What 2 viruses cause HFMD
Coxsackie A and EV-A71
What virus is causing large outbreaks of HFMD in the Asia-Pacific region and the serious complication?
EV-A71: Brainstem Encephalitis (rhombencephalitis) predominantly affects gray matter
what virus cause herpangina
coxsackie A
What 2 viruses that cause acute hemorrhagic conjunctivitis
EV-70 and Coxsackievirus A
2 Sx of acute hemorrhagic conjunctivitis
Watery discharge that begins in one eye and progresses to the other eye
Subconjunctival hemorrhage seen in most cases
What 2 viruses cause Generalized infection of Newborns?
Echovirus, Coxsackie B
What are the ○ Two Main manifestations of generalized infection of newborns?
§ Myocarditis (CV-B) CFR 30-50% Fulminant Hepatitis (Echovirus), CFR >50%
What is the name of the virus that caused an outbreak of serious respiratory infections in children in 2014
EV-68
What serious side effect is associated with the virus that caused serious respiratory infections in children in 2014?
acute flaccid paralysis
