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cdc yellowbook > Vial infection (A-D) > Flashcards

Vial infection (A-D) Flashcards

1
Q

what is B-virus?

A

Macacine herpesvirus 1 - enveloped, double-stranded DNA virus
- family Herpesviridae, genus Simplexvirus.
- commonly referred to as herpes B, monkey B virus, herpesvirus B, herpesvirus simiae

B virus is commonly found among macaques, a genus of Old World monkeys.

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2
Q

how are B virus transmitted?

A
  • bites or scratches from an infected macaque
  • contact with body fluids or tissues of an infected macaque
  • human-to-human possible
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3
Q

what is fatal ratio of B virus not treated?

A

70%

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4
Q

who is at greatest risk for B virus infection?

A

lab workers, vet
chidren

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5
Q

what are symptoms of B virus infection?

A

occurs within 1 month of exposure
- influenza-like symptoms
- vesicular lesions near the exposure site
- localized neurologic symptoms (pain, numbness, itching)
- abdominal pain
- spread to CNS - acute ascending encephalomyelitis –> death or serious complication
- respiratory failure associated with ascending paralysis is the most common cause of death

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6
Q

how to diagnose B virus infection?

A
  • collect specimens - only at National B virus resource center
  • B virus-specific antibodies in serum is also diagnostic: at time of injury and 14-21 days later for serological testing
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7
Q

for suspected exposure of B virus, what antiviral tx should be started as postexposure prophylaxis in high-risk exposures?

A

valacyclovir, alternative - acyclovir

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8
Q

how to treat B virus infection if confirmed?

A

IV acyclovir or ganciclovir

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9
Q

what family and genus is chikungunya virus belong to?

A

family Togaviridae, genus Alphavirus - single stranded RNA

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10
Q

what species of mosquito cause chikungunya?

A

Aedes spp - Aedes aegypti and Ae. albopictus

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11
Q

when do you become viremic after a bite of chikungunya causing mosquitoes?

A

2-6 days of illness

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12
Q

what are other ways of transmission of chikungunya virus ?

A

bloodborne transmission, maternal-fetal - greatest risk in perinatal period when the mom is viremic at the time of delivery!

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13
Q

what % of people infected with chikungunya virus will remain asymptomatic?

A

3-28%

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14
Q

what is incubation period of chikungunya virus?

A

3-7 days (range 1-12 days)

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15
Q

what are the symptoms of chikung?

A

sudden onset of high fever 39 and joint pains

-fever can be biphasic
-joint symptoms are severe, can be debilitating, and usually involve multiple joints, typically bilateral and symmetric

-conjunctivitis, headache, myalgia, nausea, vomiting, rash (maculopapular usually on trunk and extremities, but can be on palms, soles and face)

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16
Q

what lab findings can you expect when you have chikingu?

A

increased creatinine and liver function tests, lymphopenia, thrombocytopenia

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17
Q

what are the serious complications of chikingu?

A

hepatitis, myocarditis, neurologic disease (cranial nerve palsies, Guillain-Barre syndrome, meningoencephalitis, myelitis) , ocular disease (uveitis, retinitis), acute renal disease, severe bullous skin lesions

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18
Q

how long dose the actue symptoms last when you have chikung?

A

7-10 days

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19
Q

what are the relapse symptoms of Chikung?

A

rheumatologic symptoms in months after acute illness

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20
Q

how to diagnose Chikung?

A
  • clinical features
  • serum detection of virus, viral nucleic acid or virus-specific IgM and neutralizing antibodies
21
Q

what is the vaccine for Chikung? age indication?

A

IXCHIQ (manufactured by Valneva)- live attenuated vaccine ; 18 years and older

22
Q

what are the adverse reactions with IXCHIQ vaccine?

A

> 10% rate - injection site tenderness, headache, fatigue, myalgia, arthralgia, fever, nausea;
severe or prolonged chikung-like adverse reactions in some persons

23
Q

precaution and contraindication of IXCHIQ vaccine?

A

contraindication - immunocompromised conditions, history of severe allergic reaction to any component of the vaccine

precaution - pregnancy or breastfeeding

24
Q

what is coronavirus?

A

single-stranded, positive-sense RNA virus
family Coronaviridae
genus Betacoronavirus

25
Q

people with Covid-19 can be infectious from which days up to which days?

A

1-2 days before and up to 8-10 days after symptoms begins.

26
Q

who is at increased risk of severe illness from Covid-19?

A

-50 years and older
-immunocompromised
-with certain underlying medical conditions

-pregnant - preterm birth, stillbirth, or other pregnancy complications if infected while pregnant

27
Q

what is multisystem inflammatory syndrome (MIS) associated Covid-19?

A

rare but serious condition in which different parts of the body become inflamed, 2-6 weeks after acute infection.

28
Q

what are the testings for Covd-19?

A
  1. nucleic acid amplication testing (NAATs) - highly sensitive and specific, takes 1-3 days, PCR test
  2. antigen test - less sensitive than NAATs, particularly among asymptomatic people.
    FDA recommends repeat testing following a negative antigen test for a total of 2 antigen tests for people with symtoms or 3 antigen tests for people without symptoms, each performed 48 hours apart.
29
Q

name the covid treatments available

A

paxlovid - nirmatrelvir with ritonavir - within 5 days of symptom onset BID for 5 days

Velkury - remdesivir - within 7 days of onset - IV for 3 days

Lagevrio - Molnupiravir - within 5 days of onset - 4 pills bid for 5 days

30
Q

what virus cause dengue?

A

single stranded RNA
genus Flavivirus, dengue virus 1, 2, 3, or 4 (DENV1-4)

31
Q

which mosquitoes species transmit Dengue virus?

A

Aedes aegypti,
Aedes albopictus

32
Q

how long does viremia last for dengue?

A

7 days - bloodborne transmission is possible

33
Q

is perinatal DENV transmission possible?

A

yes, near the time of birth

34
Q

where is dengue enedmic to?

A

tropics and subtropics - Puerto Rico, US Virgin Islands, US-affiliated Pacific Islands

Sub-Saharan Africa, Latin America, Asia

35
Q

how many people are affected by Dengue per year?

A

> 50 million cases

36
Q

compared to malaria, Dengue is more of a risk in which areas?

A

urban and residential areas

37
Q

what % of DENV infections are asymptomatic?

A

40-80%

38
Q

about what % develop severe, life-threatening disease from dengue?

A

5% or less

39
Q

what is the incubation period of Dengue?

A

5-7 days

40
Q

what are 3 phases of dengue?

A
  1. febrile phase - 2-7 days, can be biphasic; other symptoms are headache, retro-orbital pain, bone, joint, muscle pain; macular or maculopapular rash, minor hemorrhagic manifestations, including ecchymosis, epistaxis, bleeding gums, hematuria, petechiae, purpura, or a positive tourniquet test result
  2. critical phase -
  3. convalenscent phase
41
Q

what are the symptoms of febrile phase of Dengue?

A
  • fever 2-7 days, can be biphasic; other symptoms are headache, retro-orbital pain, bone, joint, muscle pain; macular or maculopapular rash, minor hemorrhagic manifestations, including ecchymosis, epistaxis, bleeding gums, hematuria, petechiae, purpura, or a positive tourniquet test result
42
Q

what are the warning signs of progression to severe dengue in febrile phase?

A

occur in the late febrile phase around the time of defervescence (38 degree) - severe abdominal pain, difficulty breathing, extravascular fluid accumulation, progressive incresae in hematocrit (hemoconcentration), postural hypotension, lethargy or resetlessness, liver enlargement, mucosal bleeding, persistent vomiting.

43
Q

when does the critical phase start and what are the symptoms of critical phase of dengue?

A

begins at defervescence, and typically lasts 24-48 hours

plasma leak (marked increase in vascular permeability) - ascites or pleural effusions, hemoconcentration, hypoproteinemia

hypotension, severe hemorrhagic manifestations (hematemesis, melena, menorrhagia), irreversible shock and death; uncommon - encephalitis, hepatitis, myocarditis, pancreatitis
lab finding: elevated aspartate aminotransferase, alanine aminotransferase, hyponatremia, leukopenia, lymphopenia, thrombocytopenia, normal erythrocyte sedimentation rate

44
Q

why is dengue in pregnancy more risky for infants?

A

placental transfer of maternal IgG against DENV from a previous maternal infection might increase risk for severe dengue among infants infected at 6-12 months of age when the protective effect of antibodies wanes.

45
Q

how to diagnose dengue for patients presenting 7 or less days after fever onset?

> 7 days?

A

0-7 days - nucleic acid amplification tests and IgM

> 7 days - IgM testing

46
Q

how long does IgM detected after dengue?

A

90 days

47
Q

which medications should be avoided when infected with dengue?

A

aspirin, NSADs, meds with anticoagulant properties

48
Q

how to treat dengue?

A

no antiviral, IV fluid when plasma leakage; no steroid except in cases of autoimmune-related complications

49
Q

what is the name of dengue vaccine and what age and condition is it indicated?

A

Dengvaxia vaccine; age 9-16 years with lab-confirmed previous dengue infection who are living in areas of US where dengue is endemic - American Samoa, Puerto Rico, US Virgin Islands, Federated States of Micronesia, Republic of Marshall Islands, Republic of Palau

cdc yellowbook (26 decks)

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