Questions from S 17 Flashcards
Which virus is associated with:
children in swimming pools
Lesions which burst like smelly cheese
Molluscum contagiousum
Which virus is associated with:
Farmers - lesion on hand
Goats/ sheep - Orf (parapox)
Cows - Cowpox (orthopox)
What is incubation period of these viruses?
HAV
HBV
HCV
HAV 15-50 days
HBV 1 month - 6 months
HCV 6 weeks - 6 months
What is incubation period of these viruses?
HSV
VZV
Polio
Influenza A
Rabies
HSV 2-14 days
VZV 7-21 days
Polio 3-21 days
Influenza A 1-4 days
Rabies 4 days - 19 years
Which virus are these famous people associated with?
Professor David Dane
Baruch Blumberg
Baruch Blumberg - American doctor. Discovered surface antigen for hepatitis B in Australian aborigine people. Demonstrated HBV could cause cancer. Worked on HBV screening tests and vaccine development
Professor David Dane - described the whole virus responsible for HBV with electron microscopy
Which virus are these famous people associated with?
Michael Houghton
Charles Rice
Harvey J. Alter
HCV
Harvey J. Alter - identified that an unknown virus was the cause of chronic hepatitis
Michael Houghton identified HCV genome in blood. Virus named at this point. He also co-discovered HDV genome
Charles Rice - significant work on HCV included proving that HCV alone could cause hepatitis
In 2020 all 3 shared the noble prize for medicine
Which virus are these famous places associated with?
Jos plateau
First Lassa virus outbreak in Nigeria
Nun missionaries died
Major outbreak occurred in town of Lassa further east of Nigeria
Patient bitten by dog in Zimbabwe
What information do you want to know?
Country - presumably Zimbabwe is red-list country
Bite - depth, location- presumably Cat 3 exposure
Patient - are they immunised? Are they immunosuppressed?
Red country + Cat 3 exposure = Red compositve risk
Patient bitten by dog in Zimbabwe
What is the initial management?
(not rabies specific)
Thorough washing for 15 mins with running water
Then use alcohol 70% or iodine
Tetanus booster
Patient bitten by dog in Zimbabwe
Deep bite
What is the initial management - rabies specific
Immunocompetent - previously vaccinated
Immunocompetent - not previously vaccinated
Immunocompromised
Red country
Cat 3 exposure - bite breaking skin
Composite risk - Red
Immunocompetent - previously vaccinated
Booster days 0/7
Immunocompetent - not previously vaccinated
4x vaccines - 0, 3, 7 , 21
Plus HRIG
Immunocompromised
5x vaccines - 0,3, 7, 14, 30
Plus HRIG
Then send sample for antibody testing after completed immunisation
Patient bitten by dog in Zimbabwe
Given vaccine at time.
HRIG not available
Returns home week later with parasthesia, and fever
What is most likely diagnosis?
Rabies
Parasthesia/ numbness/ fasiculations and fever are initial symptoms of rabies
Incubation period 4 days- 19 years
Shorter incubation if bites closer to head/ neck
Patient admitted with parathesia, numbness, fasciulation following rabies exposure
How to diagnose rabies?
Saliva - Rabies PCR
CSF - Rabies PCR
Skin nuchal biopsy - Rabies PCR and immunofluorescence antibody staining (pos after 1 week)
Brain biopsy - negri bodies
Patient dies with rabies
What is seen on brain biopsy?
Negri bodies
Oval eosinophilic inclusions in neurones
Pathgnomic of rabies
Typically found in brainstem/ hippocampus
Why is rabies antibody testing not performed?
Rabies antibody testing is only useful if no rabies vaccine or HRIG has been given
Antibodies can be requested in CSF sample to check for intra-thecal antibody production
What is the case fatality rate of Rift Valley Fever in children?
Rift Valley Fever in children
case fatality rate 1%
Case fatality rate 50% if haemhorragic manifestations develops
