Pox virus

Question 1

2 dx caused by pox virus for which humans rep the primary host and reservoir

Answer 1

Molluscum contagiosum

Variola

Question 2

variola major ( Smallpox)

Answer 2

Eradicated in 1977.
spread by respi route.
37-88% of unvaccinated become infected.
inc- 7-17 days ave 10-12 days.
Prodormal phase- 2-3 days of high fever >40C, severe headache, backache.
fever subsides w an examthem covere the tngue mouth oropharync.
after 1 day, skin lesions in a centrifugal pattern w the face arms and legs more heavily than trunk.
begin as macules (day1-2), lesion all insuchrony become 2-3mm papules (days2-4) and eveolve to 2-5mm vesicles (day4-7) and 4-6mm pustules (day5-15)
pustules umbilicate, collapse, form crusts beginning in the second week.
immunity- life long.

Question 3

small pox dx

Answer 3

electron microscopy.
viral culture.
PCR.
dx test of choice: Tzanck smear- multinucleated cells of varicella. ff by confirmatory testing w PCR or DFA

Question 4

tx

Answer 4

strict isolation and protection. only vaccinated persons should tx px.
Cidofovir modified onfections by other orthopoxviruses and may be indicated.

Question 5

Vaccine

Answer 5

Vaccinia virus ( VACV) 
Live vaccine.

multiple puncture technique.

bet3-5 days: papule.
day 5-8 pustular
Day 8-10: maximum size
pustule dries from center outward revealing pathognomonic Umbilicated pustule.
day 14-21: scab that separates. resulting in a pitted scar.

mgt expectant.
vaccinated pxs may have fever on 8-10th day.

Question 6

generalized vaccinia eruption

Answer 6

day 6-9.
lesions are papulovesicles that become pustules and involute in 3 weeks.

dx confirmed by biopsy; viral culture and PCR.

VIGIV may be beneficial.
vaccine immune globulin intravenous.

Question 7

post vaccination follicular eruption

Answer 7

9-11 days after vaccination. multiple follicular erythematous papules appeared primarily on face trunk and proximal extremities. lesions are mildly pruritic.