Reddy: Vector Borne and Zoonotic Infections/ Bioterrorism Flashcards

1
Q

New Viral Diseases (since 1976):

A
  • Ebola Fever
  • Adult T Cell Leukemia (HTLV)
  • AIDS
  • Hepatitis C
  • Hantavirus
  • HHV8
  • SARS
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2
Q

Re-Emerging Viruses (severe epidemics):

A
  • Yellow Fever
  • Dengue Fever
  • Measles Virus
  • West Nile Virus
  • St.Louis Encephalitis Virus
  • Monkeypox Virus
  • Pandemic flu
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3
Q

Weapons of Bioterrorism:

A

Small pox virus

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4
Q

Factors Contributing to Emergence of Infectious Diseases:

A

Ecological/Environmental Changes: for example, weather anomalies and Hantvirus pulmonary syndrome

Behavior: for example, sexual behavior/IV drug use and AIDS

Human Demographics: for example, urbanization/increased population density and Dengue Fever

Technology and Industry: for example, blood tissue products for medical use and AIDS, HBV and HCV

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5
Q

Possible Causes of Emerging Diseases:

A
  • Infected human host or reservoir
  • Human-transported vertebrae host (legal or illegal)
  • Storm-transported vertebrae host (bird)
  • Intentional induction (terrorist event)
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6
Q

Last Case in US:

Two Reserves for Smallpox:

A

Last Case in US: 1949; eradicated from the world in 1977 (stop vaccinating for it in the US in 1972)

Two Reserves for Smallpox:
o CDC (Atlanta, US)
o Institute of Virus Preparations (Moscow, Russia)

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7
Q

Smallpox

Genus:
Structure:
Genome:

A

o Genus: Orthopoxvirus
o Structure: brick shaped, enveloped
o Genome: dsDNA; replicates in cytoplasm

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8
Q

Smallpox

Disease Symptoms:

A
o	Fever and chills
o	Headache 
o	Malaise
o	Sore throat
o	Cough
o	Backache
o	Painful skin lesions (centrifugal rash that scabs and scars)
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9
Q

Smallpox

Incubation Period:
Transmission:

A

Incubation Period: 10-14 days (for both variola major and minor)

Transmission: respiratory route (stable in environment); also direct contact

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10
Q

Smallpox
Types of Disease
Based on mortality:

A
Variola major (~30% mortality)
Variola minor (~1% mortality)
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11
Q

Flat-type smallpox:

A

Flat-type smallpox: RARE; slow evolution of flat, soft, focal skin lesions (high mortality, especially in unvaccinated)

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12
Q

Hemorrhagic-type smallpox:

A

Hemorrhagic-type smallpox: RARE; extensive mucosal hemorrhage and intense toxemia (die before lesions appear)

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13
Q

Smallpox

Virus
Genus
Replication
Incubation
Distribution
Growth of Eruptions
Pustules
Scab Formation
Scab Separation
Scaring
A
Variola
Orthopoxvirus
Cytoplasm
7-17 days
Face, palms and soles
Synchronous
Firm and deep
10-14 days after rash onset
14-28 days after rash onset
Yes
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14
Q

Chickenpox

Virus
Genus
Replication
Incubation
Distribution
Growth of Eruptions
Pustules
Scab Formation
Scab Separation
Scaring
A
VZV
Herpesvirus
Nucleus
14-21 days
Trunk
Different Stages
Soft and superficial
4-7 days after rash onset
<14 days after rash onset
No (normally)
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15
Q

Smallpox

Diagnostic Tests:

A

Skin Samples:
• Electron microscopy (EM)
• Immunoflurorescence
• PCR

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16
Q

Smallpox

Vaccination:
Post-Exposure Therapy:

A

Pre-Exposure Preventive Vaccine: uses a special needle (bifurcated)
• No longer part of vaccine regimen in the US (singe 1972)
• US government has enough smallpox vaccine to effectively respond to a smallpox outbreak

Post-Exposure Therapy:
• Supportive therapy
• Antibiotics for secondary infection
• Antivirals against it are under investigation currently

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17
Q

Monkeypox

Similar signs and symptoms to:
Originated:
People got sick after having contact with:

Transmission:

A

Similar signs and symptoms to smallpox: mortality rate was higher BEFORE the eradication of smallpox

Originated in West and Central Africa in the 1970s: first time reported in the US was in 2003

People got sick after having contact with prairie dogs infected with monkeypox

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18
Q

Monkeypox

Transmission: direct contact with infected wild and exotic mammalian pets
- Person-to-person transmission is rare

A

Transmission: direct contact with infected wild and exotic mammalian pets
o Person-to-person transmission is rare

19
Q

Monkeypox

Incubation period:
Clinical Features:
Prevention:

A

Incubation period: 10-14 days

Clinical Features: hard to differentiate from smallpox
- Monkeypox produces a generalized pustular rash with smaller lesions, fever and minor toxemia

Prevention: CDC recommends smallpox vaccination to protect people exposed to monkeypox virus

20
Q

Arboviruses

Transmission:
Genome:

A

Transmission: anthropod vectors (main vectors are flies and ticks)

Genome: RNA

21
Q

Arboviruses: (3)

A

Togaviridae
Flaviviridae
Bunyaviridae

22
Q

Togaviridae: (3)

A

Togaviridae: EEE, Sindbis, Rubella virus

23
Q

Flaviviridae: (6)

A

Flaviviridae: WNV**, DV, YFV, SLE, JE, Hepatitis C Virus

24
Q

Bunyaviridae: (1)

A

Bunyaviridae: Hanta virus

25
Q

Hantaviruses
First outbreak in US:
Transmission:

A

First outbreak in US: 1993 (SW US)

Transmission: rodent borne (deer mouse); aerosolization of rodent excreta
- No person-to-person transmission

26
Q

Hantaviruses

Genome:
Structure:
Viral Entry:

A
  • Genome: -ssRNA; replication in cytoplasm
  • Structure: enveloped
  • Viral Entry: cellular receptors and subsequent endocytosis
27
Q

Hantaviruses

Disease Symptoms:
Early Symptoms:
Late Symptoms:

A

Disease Symptoms: causes respiratory distress syndrome (Hantavirus Pulmonary Syndrome)

Early Symptoms: fever, chills, headaches, SOB, N/V/D, dizziness, abdominal/back/chest pain

Late Symptoms: cough, sweats, SOB

28
Q

Hantaviruses

Diagnosis:

A
  • Virus isolation
  • RT-PCR
  • Immunohistological technique
29
Q

Hantaviruses

Treatment:
Prevention:

A

Treatment: no treatment or cure (need to provide support through severe respiratory distress)

Prevention: control mice in and outside of house

30
Q

Ebola Virus

Family:
Genus:

A

Family: Filoviridae
Genus: Filovirus

31
Q

Ebola Virus

Transmission:

A

Transmission: close contact and dirty needles (contact with blood or secretions)

32
Q

Ebola Virus

Viral Structure:

A
Helical nucleocapsid
–ssRNA genome
Composed of 7 polypeptides:
-	 Nucleoprotein
-	Glycoprotein
-	Polymerase
-	4 other undesignated proteins
33
Q

Ebola Virus

Reservoir:
Viral Entry:

A

Reservoir: no know reservoir that harbors he virus has been identified
Viral Entry: mechanism unknown

34
Q

Ebola Virus

Treatment:

A

No pre- or post-exposure prophylaxis

No antiviral drug has been show to be effective

35
Q

Ebola Virus

Clinical Features:
Lesions found:
Some strains cause:

A

Clinical Features: causes a severe hemorrhagic fever

Lesions found in liver, spleen and kidney

Some strains cause massive destruction of the liver (Ebola Sudan, Zaire and Reston- only in monkeys)

36
Q

Pandemic Flu

Definition:
Flu Basics:

A

Definition: a disease that can erupt globally

Flu Basics:

  • Only 4 know Influenza A subtypes circulating among humans (H1N1, H1N2, H3N2, H7N2)
  • H5N1 is an avian flu that has affected a few humans, but person to person spread is limited (concern arises due to H5N1’s ability to mutate, with the possibility that one day it could evolve into a strain easily transmitted from person to person)
37
Q

Seasonal Flu:

A
  • Follow seasonal pattern (winter in temperature climates)
  • Usually some immunity from the previous exposure (healthy adults not at risk for serious complications)
    o Very young, elderly, and those with underlying health conditions are
  • Vaccine available and antivirals as well
  • Low mortality rate
  • Manageable impact on domestic and world economy
38
Q

Pandemic Flu:

A
  • Rare occurrence
  • People have no previous exposure and little/no pre-existing immunity
  • Even healthy people at increased risk for serious complications
  • Vaccines would probably not be available at the beginning of the pandemic; antivirals would run low
  • High mortality rate
  • Drastic impact on domestic and world economy
39
Q

Avian Flu (H5N1)

A
  • Pandemic starts when the virus meets these 3 criteria:
    o New influenza subtype
    o Able to infect humans and cause serious illness
    o Able to spread easily among humans
  • H5N1 only fits the first two criteria (would have to undergo reassortment or adaptive mutation to be able to be spread person to person)
  • No vaccine; resistant to Amantidine and Ramantidine; need to use Oseltamivir and Zanamavir
40
Q

Severe Acute Respiratory Syndrome (SARS)

First outbreak in:
Family:
Genus:

A

First outbreak in 2003 in Hong Kong: then spread worldwide

Family: Coronoaviridae
Genus: Coronavirus

41
Q

Severe Acute Respiratory Syndrome (SARS)

Viral proteins identified: (6)

A
o	Polymerase protein
o	Spike protein (S)
o	Small membrane protein (E)
o	Membrane protein (M)
o	Nucleocapsid protein (N)
42
Q

Severe Acute Respiratory Syndrome (SARS)

Incubation Period:
Symptoms:

A

Incubation Period: 2-7 days

Symptoms:
o High fever and chills
o Headache, discomfort and body aches
o Mild respiratory symptoms at outset (some)

43
Q

Severe Acute Respiratory Syndrome (SARS)

Diagnosis:
Treatment:

A

Diagnosis:
o Detection of serum Ab to SARS-CoV
o Isolation in cell culture of SARS-CoV from clinical specimen and PCR confirmation
o Detect SARS-CoV RNA by RT-PCR

Treatment: none at this time