Second Set of VIR Cards (Dz-specific) Flashcards
Common Cold (most common cause)
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Picornaviridae; Genus = Enterovirus; Species = Human rhinovirus
Epidem = worldwide; worse in fall/winter; most common cause of infection in humans
Pathogen w/ s/sx = spread via aerosol AND indirectly via contaminated surfaces; prefer lower temps of nasopharynx; causes common cold (sneezing, nasal discharge, sore throat, cough, headache, maybe chills but few systemic sx), lasts 1 week; does NOT grow in low pH (i.e. highly labile at low pH)
Dx = clinically, but could technically dx from cell culture
Vaccines? = no, too many serotypes (>100)
Tx = not really, supportive/sx mgmt
Poliomyelitis
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Picornaviridae; Genus = Eneterovirus; Species =
Epidem = eradicated from W hemisphere; still 1000-2000 cases/yr in: Afghanistan, India, Nigeria and Pakistan; epidemics used to occur in summer/fall; was assoc’d w/ development: both incr conc of poop + maybe hygiene hypothesis?
Pathogen w/ s/sx = fecal-oral route; 10-14 day incubation; only 1% develop sx
Four grades: 1) asymptomatic infection; 2) abortive (short course w/ h/a sore thr, n/v), 3) non-paralytic p-m (aseptic meningitis), 4) paralytic p-m
oropharynyx/small bowel—>bloodstream—>CNS (also retrograde axonal trans) perferring motor neurons in ant. horn of spinal cord + brain stem—>neuronal death —>paralysis (resp paralysis if also brain stem = “bulbar poliomyelitis”)
Dx = isolation (throat, stool, CSF)—>CPE—>specific anitsera; OR elev. Ab titer
Vaccines? = Salk (“IPV,” killed, given IM); Sabin (“OPV,” live-atten. given PO)
Tx = sx mgmt; resp. support; PT after
Coxsackie Viruses
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Picornaviridae; Genus = Enterovirus
Epidem = daycare (b/c F-to-O and stable in environment)
Pathogen w/ s/sx = F-to-O
TYPE A: Skim/Muc-Memb tropic
Herpangina (fev, sore thr, pharyngeal lesions); Hand, foot and mouth dz; Asep meningitis; Paralytic disease (rare)
TYPE B: Viscerotropic
pleurodynia (unilateral intercostal pain; possible orchitis); myocarditis; aseptic menin; paralytic dz (rare); possibly: Type I DM, chronic fatigue?
Dx = isol/culture, elev [Ab] or PCR of CSF
Vaccines? = None
Tx = None
ECHO VIRUSES
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = picornaviridae; Genus = enteroviruses; Species = Enteric Cytopathic Human Orphan viruses
Epidem = worldwide; daycare, again b/c non-env and therefore stable in the environment
Pathogen w/ s/sx = F-to-O trans; leading cause of aseptic meningitis; broad spec of dzs e.g. multiple rashes
Dx = isolation/cuture; sero tests not useful b/c >32 serotypes to date (of 67 total in enterovirus genus!)
No vaccine; no tx
Other Enteroviruses
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Picornavirus; Genus = Enteroviruses
Epidem = ?
Pathogen w/ s/sx =
EV 70 —> acute hemorrhagic (of bulbar) conjuctivitis
EV 71 —> H,F&M dz; leading cause of viral CNS dzs
EV 72 —> HAV
Dx = ?
No vaccines/tx
Rotaviruses
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Reoviridae; Genus = Rotavirus
Epidem = Endemic worldwide; peaks in winter; most deaths in poorer countries; children <2 y/o
Pathogen w/ s/sx = F-to-O trans; 2-day inc then gastroenteritis (n/v + diarrhea); dehydration —> death
Dx = usually clinical; radioimmunoassay or ELISA from stool sample
Vaccines? = yes, two orals now: Rotarix is live monovalent for more common U.S. serotype; Rotateq reassortment of surface Ags from 5 human serotypes on a live bovine strain
Tx = No antiviral; WASH YO HANDS
Norwalk virus
Family = ?; Genus = ?
Epidem = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Calciviridae; Genus = Norovirus
Epidem = cruise ships/nursing homes/camps, highly contagious; easily spread via food esp shell fish/salads
Pathogen w/ s/sx = F-to-O trans; gastroenteritis; incr susceptibility if O blood type
Dx = usu. clinical; PCR of stool available for Public health measures
Vaccines? = in development
Tx = none; hygiene, rehydration-
adenovirus
Family = ?; Genus = ?
Epidem/trans = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = adenviridae
Epidem/trans = f-to-o—most common for kiddos et leur familles; aerosol; direct inoculation of eye (e.g. with tonometer/fingers); common in military
Pathogen w/ s/sx = 3-10 incubation; persists in ADENOIDS, tonsils—> resp; pink eye (i.e. epidemic keratoconjunctivitis); gastroent.
Dx = cell culture, elev titer, serologic (hemagglutination inhibition and complement fixation)
Vaccines? = no
Tx = no
Influenza
Family = ?; Genus = ?
Epidem/trans —>what strains, how are they different? how do they mutate?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = orthomyxoviridae; Genus = e.g. Influezavirus A
EPIDEMIOLOGY AND STRAINS
3 strains:
A = worst
B = less severe, epidemics q3-6 yrs
C = NBD
MINOR EPIDEMICS (i.e. yearly) due to antigenic DRIFT (i.e. mutation w/in existing RNA segments, specifically H gene); we’ll have partial immunity to this from previous immunization/illnesses
MAJOR PANDEMICS due to antigenic SHIFT involving reassortment of animal and human influenza strains; must be an H-shift, even worse if there is concomitant N-shift; this will be a Novel H (and N) which means we will have NO immunity
TRANSMISISON: droplets and surface contamination
Pathogen w/ s/sx = even though locatlized infection in resp tract (i.e. usually no virema)—>systemic sx incl. f/c and myalgia from pro-inflammatory mediators; destroys cilia of resp tract
—can develop 2° viral pneumonia—>leads to bacterial pneumonia
Dx = rapid uses fluorescent Ab on throat swab specimen; compare acute and convalescent Ig levels
Vaccines = usually killed virus trivalent w/ 2 A strains and 1 B strain given IM
FluMist = polyvalent, live, attenuated —>induces IgA
new quadrivalent just out w/ 2 A and 2 B strains
Tx = neuraminidase inhibitors (e.g. osteltavir, zanamivir) for both A and B; amantadine and rimantidine—>only A and then only sub-set of As
RSV
Family = ?; Genus = ?
Epidem/trans —>Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Paramyxoviridae
Epidem/trans = trans like flu (direct droplets and indirect surfaces); outbreaks in winter; occurs worldwide and virtually everyone has been exposed by 3 y/o
Pathogen w/ s/sx = LOWER resp tract—>bronchiolitis and pneumonia more severe in infants—>hospitalization; can have immunopathogenic mech w/ maternal IgG forming immune complexes and injuring baby’s lungs
Dx = rapid antigen testing of resp secretions; CPE w/ giant, mulitnuc cells; RT-PCR; 4x rise in Abs
Vaccines? = no vaccine
Tx = inhaled ribavirin (unsure how well it works); maybe combine with hyperimmune Igs
Croup
Family = ?; Genus = ?
Epidem/trans = ?
Pathogen w/ s/sx = ?
Tx = ?
Family = Paramyxoviridae; (Genus = Respirovirus & Rubalavirus;) Species = Parainfluenza (most common cause; other viruses can cause similar syndrome)
Epi/trans—> first three years of life
Pathogenesis = “acute laryngo-tracheo-bronchitis” causing dyspnea and stridor
Tx = glucocorts w/ bad cases
SARS
Family = ?
Epidem / Trans = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Coronaviridae
Epidem/trans = human-to-human trans
Pathogen w/ s/sx = 1-3 days incubation; severe infection uncharacteristic of other coronaviruses; pneumonia w/ diffuse edema—>hypoxia; binds to ACE-2 which may play role in edema
Dx = PCR- and Ab-based tests used to dx SARS
No vaccine nor specific antiviral; ribavirin + steriods
Hepatitis A
Family = ?
Epidem = ?
Trans = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = picornaviridae
Epidem = overt dz less common in developing countries b/c nearly everyone seroconverts by age 5 and virus is mild chez les petits enfants; MAIS, dans les pays plus developés, il y a plus des adults immuno-naïve
Examples: 1) outdoor events w/o sanit, 2) raw shellfish contam w/ sewage; 3) within fam w/ small kid, 4) infected foodhandler, 5) imported contam food
Trans = F-to-O trans; blood if pt is viremic
Pathogen w/ s/sx = incub is 30 days; viremia—>liver—>anorexia, nausea, fever, jaundice elev. LFTs (e.g. AST); liver damage to cell lysis by replicating virions
There is no chronic stage
Dx = Anti-HAV-IgG and IgM sero assays
Vaccines? = killed IM vaccine
Tx = pooled Ig
Hepatitis B
Family = ?
Epidem = ?
Trans = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Hepadnaviridae
Epidem =
Trans = sexual, blood, perinatal, needles
Pathogen w/ s/sx = 70 incubation;
Has chronic phase in 5% of cases. —>liver carcinoma and chornic hepatitis
Dx = HB-Ags from serum
Vaccines? = Yes, inactivated subunit vaccine given IM (only contain antigenic subunits)
Tx = pooled IgG for infants of known-infected mothers
Give alpha-INF w/ lamivudine, a chain-terminating RT inhibitor from HIV txs past
Hepatitis C
Family = ?
Epidem = ?
Trans = ?
Pathogen w/ s/sx = ?
Dx = ?
Vaccines? = ?
Tx = ?
Family = Flaviviridae
Epidem
20,000,000 chronically infected worldwide; men > women; caucasianc > Afr. Amer.; Age > 40 y/o; increased risk factors: coinfection (HBV, HIV), EtOH, steatosis (fat droplets in liver)
Trans
Mostly injection drug users, also: sex, vertical, tatoos; needlestick and transfusion RARE
Pathogen w/ s/sx
60 day incub.; 70-80% become chronic hepatitis pts!
Dx
PCR test of HCV RNA
Vaccines?
no, mutates incredibly fast
Tx
chronic: alpha-INF (expensive and not very effacious); consider ribavirin; new: HCV protease inhibs (telaprevir and boceprevir) can be given with other two
Hepatitis D
Family = ?
Epidem = ?
Trans = ?
Pathogen w/ s/sx = ?
Family = n/a b/c not true virus (Deltavirus genus)
Epidem = only those with Hep B; break-outs among pops w/ high HBV prev
Trans = venereal, parenteral, perinatal
Pathogen w/ s/sx = acute onset; can be life-threatening
Hepatitis E
Family = ?
Epidem = ?
Trans = ?
Pathogen w/ s/sx = ?
non-env (+)ssRNA from Hepeviridae
trans = f-to-o
contam water/food
only in developing countries
20% mortality w/ preg women
Mumps
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = paramyxoviridae
Epidem = worldwide, peaks in winter; some reccent epidemics have occured in North America
Trans = saliva—>resp droplets
Incubation = ~3 wks
Pathogenesis, s, sx = virus grows in resp epithel—>local lymph nodes—>viremia—>parotids etc.
most people are symptomic (70%)
prodrome: 1st malaise, anorexia, fever; 2nd uni- or bi-lateral parotiditis—>spreads via saliva; 3rd other encapsulated organs via viremia (e.g. testes = orchitis in 30% of post-pubertal males; meninges causing aseptic meningitis pretty common; ovaries and pancrease less common)
Dx = usu clinical; viral culture from saliva, CSF or urine; PCR also; 4x incr in IgG
Prevention = live attenuated vaccine given twice in childhood
Tx = none
Measles
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = paramyxovirus
Epidem = highly infectious! humans = sole carriers; most contagious dz known but always antigenically the same! caused dz q3 years (# non-immune incr w/ births breakdown in herd immunity)
Trans = resp drops and also tears and urine
Incubation = 2 weeks from exposure to rash
Pathogen w/ s/sx = resp to resp; growth in epithel, lymph nodes and conjunctiva; 100% attack rate (everyone exposed gets it); 1st) prodrome w/ coryza; 2) koplik’s spots (see photo); 3) pathognomonic maulopapular erythema that starts on head and spreads inferiorly
—causes syncytia; rare giant-cell pneumonia w/o rash chez les personnes sans cell-mediated immunity; show cell-med imm imprt for rash
—suppressed cell-mediated immunity—>2° infections that cane be deadly esp. in resource-limited situations = ANERGY
—Photophobia also common
—1:20 pneumonia; 2° bact. otitis media; acute encephalitis —> neuro def if survived
—1-3:1000 death rate
Dx = usu. clinically; culture, 4x incr [Ab] or PCR also available
Prevention = live, attenuated vaccine
Tx = no antiviral therapy available
Progressive Multifocal Leukoencephalopathy (PML)
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
WILL BE ON BOARDS
Family = polyomaviridae—>JC virus
Epidem = most common chez les immunodéprimées
Trans = unbiquitous
Incubation = long long time
Pathogen w/ s/sx = immunocompromizaiton causes affects oligodendrocytes causing demyelenation: visual field defects, mental status ∆s, weakness—>blindness, dementia, coma and death =(
Dx = PCR of brain biopsy or CSF
Prevention = don’t get cancer or HIV?
Tx = cidofovir may help, but really no effective tx
Subacute Sclerosing Panencephalitis (SSPE)
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = Paramyxoviridae—>MEASLES VIRUS
Epidem = kids several years after initial infection
Trans = ?
Incubation = “long incubation time”
Pathogen w/ s/sx = VERY HIGH Ig titers; Measles Ag in CSF; slow cognitive decline, psych disturbances—remissions—>terminal paralysis and blindness
Dx = titer of blood and CSF
Prevention = vaccination? still 1:1,000,000 risk of SSPE w/ vaccination as compared to 1:100,000 w/ actual dz
Tx = none =(
Scrapie
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Prevention = ?
Sheep prion dz
genetic predisposition (inbred sheep at increased risk)
sheep goes crazy scrapes off all its skin
cannot be prevented with UV sterilzation, alyklating agents or formaldehyde
Kuru
Family = ?
Epidem = ?
Trans = ?
Pathogen w/ s/sx = ?
Family = prion dz
epidem = limited to Foré
Trans = ingestion, direct injection into brain of chimps, possibly via open skin?
Pathogen = Kuru is a progressive degenerative disorder of the CNS, especially the cerebellum; similar to Scrapie
CJD
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Creutzfeld Jacob Disease
Family = prion dzs
Epidem = most cases in 50-70 y/o’s
Trans = 1) sporadic = most cases (sCJD); 2) genetic predisposition (fCJD familial); 3) iatrgoenic (iCJD) **Not linked to diet—vegetarians and meat-eaters have similar incidence
Incubation = clinically with: brain biopsy showing SE; imaging and EEG; definitely with: antiprion Abs
Pathogen w/ s/sx = dementia w/ behav ∆s/mem loss/confusion and myoclonic jerking
Dx = ?
Prevention = no vaccine
Tx = no tx
Variant CJD
- A spongiform encephalopathy of cows (“mad cow disease”) reached epidemic status in Great Britain as a result of using brains and bone marrow from cows and sheep in the manufacture of bovine food.
- An outbreak of “atypical human Creuzfeld-Jacob disease” (vCJD) in Great Britain has been linked epidemiologically to eating beef from infected cows. Cows were infected by being fed dead cow brains in their feed. =/
EEE
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = togaviridae (classified also as an arbovirus)
Epidem = only in summer/when mosquitoes are alive; mostly children affected; swampy areas and wetlands are worst hit; also kills local horses; mostly kids <10 y/o
Trans = mosquito—>bird*—>mosquit—>horse/human (DEAD END HOSTS)
*the bird is usually unaffected
Incubation = 1 week intrinsic incubation in host (2 week extrinsic incubation in vector)
Pathogen w/ s/sx = direct viremia (delivered from mosquito’s saliva to bloodstream); sudden onset severe headach, n/v, fever—>mental status ∆s—>seizures and nuchal rigidity—>TWO OPTIONS:
1) if you survive: high %—>severe neuro sequelae
2) if a severe case: paralysis—>coma—>death
—EEE usually causes the worst dz w/ ~50% fatality rate
Dx = isolate virus or incr titer
Prevention = kill mosquitoes; wear repellent; monitor mosquito traps via PCRing ground up dead ones; killed vaccine for horses is available
Tx = none
Compare WEE to EEE
Western Equine Encephalitis
Family = togavirus
similar to EEE w/ higher incidence rate and lower death and permanent neuro sequelae rates; usually infants and adults >50 y/o
SLE
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
St. Louis Encephalitis
Family = flaviridae
Epidem = indigenous to North America more common in urban areas; adults >50y/o are most affected
Trans = maintained by bird—>mosq—>bird cycles w/ humans as DEAD END hosts
Incubation = again two: 1 week in humans two weeks in vector
Pathogen w/ s/sx = most infections inapparent but does cause moderately severe encephalitis w/ 10% fatality; sequalae uncommon
Dx = serologically
Prevention = no vaccine
Tx = no antiviral
WNV
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = flaviviridae
Epidem = urban and rural; causes the most cases of viral encephalitis per year in US now; usually in folks over 60
Trans = bird<—>mosquito—> human DEAD END host (also 10% via blood transfusion)
Incubation = same 2wks in vector 1wk in host
Pathogen w/ s/sx = <1% infected get symptomatic dz;
Dx = isolate virus from: brain tissue, blood, CSF or detect Abs in CSF or blood; PCR also available
Prevention = no vaccine; screen at bloodbanks
Tx = no antiviral
Dengue
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = flavivirus
Epidem = subtropics and tropics S.E. Asia and Caribbean
Trans = Aedes aegypti—>humans—>A. aegypti (i.e. humans are NOT dead ends!)
Incubation = 1 week in host
Pathogen w/ s/sx = fever, severe retro-orbital headache, myalgia and arthralgia (“break-bone” fever”) and rash
—Dengue Hemmorrhagic fever in those native to endemic areas (likely b/c there are 4 cross-reacting antigenic types); severe/fatal: 2nd infection immune complexes form and then either a) activates complement cascade—>incr vasc perm + thrombocytopenia OR b) virus penetrates monocytes and macrophages—>release hella cytokines
—point: hemorrhage—>hematemesis—>shock—death
Dx = isolate—>cell culture or IgM or 4X IgG at convalesecent vs. acute phase
Prevention = no vaccine; insecticides, drain stagnant water, personal protection
Tx = no antiviral
La fièvre jaune
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = flavivirus (w/in arbovirus grouping, too)
Epidem = endemic to rural tropical Africa and South America; can cause import epidemics in U.S., etc.
Trans = Aedes aegypti—>humans—>A. aegypti (i.e. humans are NOT dead end host)
Incubation = 1 week in host, 2 weeks in vector
Pathogen w/ s/sx = instant viremia due to direct injection by mosquito—>multiplies in vasc endothelium—>worsen viremia—>liver, kidney, spleen—>fever, jaundice, n/v w/ hematemesis
—high mortality, occasional subclinical cases
Dx = PCR of plasma specimen
Prevention = 17-D vaccine is live-attenuated and gives great protection
Tx = ?
Parvovirus B-19
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = parvoviridae
Epidem = super common; 50% adults are seropoz
Trans = can go transplacentally
Incubation =
Pathogen w/ s/sx = RBC precursor tropism—>inhibits RBC synth for ~1 week
—usually just leads to ERYTHEMA INFECTIOSUM w/ sometimes a TRANSIENT ARTHRITIS
—can lead to TRANSIENT APLASTIC CRISIS in pts with pre-existing erythrocytopenia (e.g. sickle); fatal w/o transfusion tx
—HYDROPS FETALIS occurs when transplacental route occurs in 1st or 2nd trimester; still can cause fetal demise (just w/o the hydrops fetalis) in 3rd trimester; massive increase in CO b/c anemia leads to edema, etc.
Dx = IgM (would not be present in immunocompromised pts so PCR from blood); fetal infection use PCR of amniotic fluid
Prevention = none
Tx = pool Ig for chronic/immunocomp. pts
Rubella
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Rubella (a.k.a. “German Measles”)
Family = togavirus (though NOT arbovirus)
Epidem = less contagious than measles; near-universal vaccination in U.S.—>last case 2005
Trans = resp drops (spread one week before and after rash!)
Incubation = 18 days
Pathogen w/ s/sx = resp epithel—>viremia; 3 days of rash w/ fever and lymphadenopathy; even subclinical cases—>lifelong immunity
—TRANSPLACENTAL: cataracts, PDA, deafness, MR; less and less a risk as you move along in pregnancy
Dx = ?
Prevention = live-attenuated vaccine (in MMR); major purpose is to prevent congenital rubella
Tx = ?
HSV-1&2
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = Alphaherpesviruses (HHV-1 & HHV-2)
Epidem = ubiquitous
Trans = saliva, vaginal secretions and lesion fluids—>eyes/breaks in the skin—>axonal transport to achieve latency
Incubation = ~7 days (CDC)
Pathogen w/ s/sx = Cold sores, ocular infections, (HSV-1) genital sores (HSV-2) and encephalitis (deadly, caused by both 1&2)
Dx = isolate and culture (causes CPE), ELISA, PCR of CSF, IgM/serology
Prevention = no vaccine
Tx = great drugs (nucleoside analogs) including: acyclovir, valacyclovir, famcilovir, pencilovir, adenosine arabinoside, iododeoxyuridine, trifluridine
Chicken Pox
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = herpesviruses —> alpha-herpesviruses —> varicella zoster (HHV-3)
Epidem = common in 4-10 y/o’s in non-vacc countries
Trans = aerosol or direct contact
Incubation = 2-3 weeks
Pathogen w/ s/sx = viremia —> prodrome w/ fever & malaise —> rash
IN ADULTS: worse; tx w/ ACV; re-activation causes shingles—> deratomal presentation VERY PAINFUL
Dx = clinically
Prevention = vaccines: pedi (oka strain = Varivax), adult (Zostavax = same strain, just 1/14 strength))
Tx = can try ACV in severe cases; usually just palliative
CMV
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = Herpesvirus—>betaherpesvirus (HHV-5)
Epidem = ubiquitous
Trans = blood, tissue, body secretions (URINE DIAPERS)
Incubation = ?slow? (see Dx)
Pathogen w/ s/sx = latency in leukocytes (powerful T-cell evasion strategy); usually subclinical, but also: Most common cause of congenital abnormalities in U.S.; Pneumonia, retinitis, esp in immunocompromized (esp pre-HAART)
Dx = have to PCR b/c grows very slowly
Prevention = wash hands, warn pregnant women
Tx = gancilovir, Vitravene (direct to retina)
EBV
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = herpesviruses—>gammaherpesviruses (HHV8)
Epidem = ubiq. (>90% U.S. adults positive)
Trans = kissing/saliva
Incubation = ~(2-?)4(-6? slides conflict) wks
Pathogen w/ s/sx = infects oral epithel—>blood—>B-cells—>immorts B-cells—>T-cells clear things up which cause “mono” sx in teens/adults (mild/asymp in kids)
—Mono sx: lymphadenopathy, hepatosplenomegaly
—in immunocomp: Burkitt’s lymphoma and nasophar. carcinoma I.E. TUMOR VIRUS
Dx =
Prevention = no vaccine
Tx = no anti-virals
HHV‐6
roseola infantum/ exanthem subitum.
• Benign rash with high fever. Rarely encephalitis.
• >90% worldwide.
• Approx 1% have HHV‐6 integration into germline
Assoc’d with MS/CFS*/epilepsy
*chronic fatigue synd
HHV-7
closely related to HHV‐6.
• “No treatment for HHV‐7 infec4on exists, but no clinical situation where such treatment would be useful has yet been discovered.”
“A virus that is looking for a dz.”
HHV-8
Kaposi’s Sarcoma Herpes Virus (KSHV)
- tumor virus that causes opportunistic infection in HIV pts not on HAART
- common in sexually-trans HIV
- No vaccine
- Tx w/ excision
B-virus
zoonosis that sometimes infects zookeepers, etc.
From Rhesus macaques
Rare but serious encephalitis
tx w/ acyclovir or immune serum
HPV
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = Papillomaviridae
Epidem = 1/3 of college-aged U.S. females have cervical infection of HPV
Trans = sexual
Incubation = ?
Pathogen w/ s/sx = condyloma (6b and 11) or cervical carcinoma (16 & 18)
Dx = Pap smear
Prevention = vaccine
Tx = ?
Burkitt’s Lymphoma
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = Herpesviridae—>Gammaherpesviridae—>EBV (HHV-4)
Epidem = common in “African children”; higher prev. in males
Trans =
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention =
Tx =
HTLV
Family = ?
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
Family = retroviruses
Epidem = ?
Trans = ?
Incubation = ?
Pathogen w/ s/sx = ?
Dx = ?
Prevention = ?
Tx = ?
