Rotavirus, Norovirus, Adenovirus, Pertussis, Exanthema

Question 1

Rotavirus

1. seasonality
2. incubation period
3. route of infection
4. syndromes

Answer 1

1. More common in spring
2. 1-3 days, up to 5-7 days
3. fecal oral
4. gastritis, gastroenteritis, enteritis

Question 2

Rotavirus

-clinical presentation

Answer 2

• Stools – liquid watery, foamy, light in color stools without blood or mucus, high volume
• Acute onset – fever, vomiting, diarrhea, meteorism, nausea, abdominal pain
• Respiratory problems may also happen – rhinitis, cough

***Some cases may be without diarrhea

Question 3

Rotavirus

-How long does symptoms last?

Answer 3

• Fever – 3-4 days
• Vomiting 2-3 days
• Diarrhea 3-7 days

Question 4

Rotavirus

1. diagnosis
2. treatment
3. is there a vaccine?

Answer 4

1. Antigen of viruses in feces, CBC, CRP, pH, electrolytes, glucose, immunochromatographic tests
2. non specific
3. yes, RotaTeq (3 doses), Rotarix (2 doses)

Question 5

Norovirus

1. seasonality
2. incubation period
3. route of infection

Answer 5

1. More common in cold months – “winter vomiting bug”, “winter flu”
2. 1-2 days
3. fecal oral

Question 6

Norovirus

-symptoms

Answer 6

-start suddenly, forceful vomiting, stool are watery or liquid, without blood or mucus

Question 7

Norovirus

-How long does symptoms last?

Answer 7

• Fever – 1 day

- Others – 2-3 days

Question 8

Norovirus

1. diagnosis
2. treatment

Answer 8

1. Antigen of viruses in feces, CBC, CRP, pH, electrolytes, glucose, immunochromatographic tests
2. non specific

Question 9

About both – rotavirus and norovirus (5)

Answer 9

1. Resistant in environment and survive – several hours on hands and weeks at the room temperature on the surfaces
2. Resistant to many disinfectants and soaps, sensitive to disinfectants that contain Cl
3. Infected person may be infectious for several weeks
4. Sheading is intensive
5. For contamination 10 copies are enough –> infection dose is low

Question 10

Adenovirus

1. seasonality
2. route of infection

Answer 10

1. More common in summer

2. fecal oral

Question 11

Pharmacological therapy of AGE (acute gastro enteritis) (4)

Answer 11

• Ondansetron (antiemetic),
• Adsorbents (Dosmectite-Smecta),
• Anti-secretory drugs – Raccadotril
• Antimotility or anti peristaltic drugs (Loperamide) –> NOT RECOMMENDED IN THE MANAGEMENT OF AGE IN CHILDREN

Question 12

Pertussis

1. clinical manifestations
2. clinical criteria

Answer 12

1. catarrhal period 1-2 weeks, whooping cough 1-6 weeks, convalescention weeks to month, no fever.
2. a person with cough lasting for more than 2 weeks and one or more of the 3 criteria –> paroxysms of coughing, post-tussive vomiting, inspiratory “whopping” or in contact with a confirmed case or apneic episodes of infant’s coughing

Question 13

Pertussis

1. complications
2. diagnosis
3. treatment

Answer 13

1. overstimulation of nervous system – apnea, vomiting after coughing, bacterial superinfections (pneumonia), coughing related problems – hemorrhages in eyes and brain, hernias
2. culture (during the first 2-3 weeks), PCR or Ab testing
3. macrolides (Azithromycin 10-12 mg/kg per day during 5 days or Clarithromycin 15-10 mg/kg per day for 5-7 days)

Question 14

Pertussis

- Testing regimen:

Answer 14

<14 days = PCR and culture,
14-21 days = only PCR,
>21 days PCR or serology

Question 15

Exanthema Subitum – Roseola infantum – 3 day fever – Sixth disease

1. etiology
2. most common in which age
3. seasonality

Answer 15

1. Herpes virus 6 or 7
2. among children of 6 months to 3 years old
3. More frequent in spring and fall

Question 16

Exanthema Subitum – Roseola infantum – 3 day fever – Sixth disease

1. source of infection
2. route of infection
3. pathogenesis

Answer 16

1. sick people, carriers
2. respiratory droplets
3. virus enters the body and multiplies in the salivary glands and leukocytes (CD46)
   - Can infect many tissues –> CNS
   - After infection, remains in latent state –> reactivation is possible

Question 17

Exanthema Subitum – Roseola infantum – 3 day fever – Sixth disease

1. incubation period
2. symptom

Answer 17

1. 5-15d. (usually 9-10 days)
2. begins with sudden febrile fever (>39) lasting 3-5 days
   - Enlarged lymph nodes (posterior cervical and occipital)
   - Possible seizures
   - Rash appears (macular or maculopapular) when fever is over –> begins in the neck, torso area –> spread to face and limbs –> lasts 1-3 days, may last only a few hours
   - Immunity is acquired for life long

Question 18

Exanthema Subitum – Roseola infantum – 3 day fever – Sixth disease

1. complications
2. diagnosis
3. treatment
4. is there a vaccine?

Answer 18

1. febrile seizures (most common), Guillain Barre syndrome, meningitis, encephalitis, organ damage
2. blood tests (leukopenia, lymphocytosis), serology (specific IgM and IgG), PCR
3. symptomatic – anti pyretic, fluids
4. no vaccine