Respiratory viruses Flashcards
The peak incidence of viral respiratory infection is in the _____
winter months
Adenovirus infection is present ______ but cases occur periodically in _________
present throughout the year
outbreaks in institutional settings- ex military trainees
The peak incidence of enterovirus respiratory disease is in the ______
late summer/ early fall
Coronavirus, influenza virus, and SRV all peak in the _____
winter
Parainfluenza virus and rhinovirus peak in the ______+
two peaks: one in fall, one in spring
Respiratory viruses are generally poor at generating_____ so re-infections are common
immune responses
Least the 10 viruses that cause respiratory illness that were covered in this class
Influenza A, B, C Enterovirus Adenovirus Parainfluenza virus Respiratory syncytial virus Rhinovirus Coronavirus Metapneumovirus Human bocavirus WU virus
Many respiratory viruses cause similar syndromes. List some symptoms that are somewhat specific for influenza
fever, malaise, muscle aches, cough, extreme fatigue
RSV causes serious ____ respiratory tract infections in ____ (age)
lower respiratory tract infections
infants 6 mo- 1 year
hospitalization is more common in boys
How are respiratory viruses diagnosed?
Culture from throat swabs, detected by immunofluorescent within 24-48 hours.
Cytopathic effects take longer to detect and may or may not be distinctive
PCR tests are available
What respiratory viruses have antivirals that can be used for treatment
influenza
RSV
ie distinguishing between rhinovirus and coronavirus is not clinically useful
What causes symptoms of the common cold?
replication of virus in the epithelial lining of the URT
irritation of nerve endings–> cough
histamines/ bradykinin–> mucus, congestion
viral replication results in killing of epithelial cells in some cases, ciliary action is often paralyzed
Describe the pathogenesis of LRT symptoms in viral infection
sloughing of dead cells blocks airways and results in dyspnea (more severe in infants)
chemotactic factors for eosinophils can exacerbate asthma/ COPD
fever from IL-1 or IFN
What is the cause of the muscle aches and malaise seen in influenza infection?
High systemic levels of IFN
What is the pathology of SARSCoV?
diffuse alveolar damage, desquamation, hyaline membranes, alveolar edema,
inflammation, syncytia formation, and thickened alveolar walls
List recommended therapies for respiratory viral illness
hydration
chicken soup-antihistamine activity
Describe how to help counsel patients about appropriate use of OTC agents for respiratory viral illness
OTCs: antihistamines, decongestants, expectorants, cough suppressants, pain relievers
recommend patients purchase drugs specific to their symptoms rather than formulated combinations (ex don’t take decongestants for influenza)
never use aspirin in kids- Reye’s syndrome
zinc- may inhibit rhinovirus proteases
What two drugs previously used to treat influenza are no longer prescribed due to high rates of resistance?
amantadine and rimantadine
What is the mechanism of action of oseltamivir and zanamivir?
neuraminidase inhibitors- block release of virus from cells, must initiate within 48 hours
What drugs can be used for respiratory syncytial virus?
aerosolized ribavirin in hospitalized infants
debate about efficacy
Palivizumab is a monoclonal antibody against RSV fusion protein, used for prevention and therapy in severe cases
** breastfeeding is protective- mom secretes anti-RSV antibodies
What is current thinking about transmission of respiratory viruses?
aerosols + many of these viruses
can survive for days on surfaces contaminated by “wet secretions”