Vial infection (A-D)

Question 1

what is B-virus?

Answer 1

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.

Question 2

how are B virus transmitted?

Answer 2

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

Question 3

what is fatal ratio of B virus not treated?

Answer 3

70%

Question 4

who is at greatest risk for B virus infection?

Answer 4

lab workers, vet
chidren

Question 5

what are symptoms of B virus infection?

Answer 5

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

Question 6

how to diagnose B virus infection?

Answer 6

• 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

Question 7

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

Answer 7

valacyclovir, alternative - acyclovir

Question 8

how to treat B virus infection if confirmed?

Answer 8

IV acyclovir or ganciclovir

Question 9

what family and genus is chikungunya virus belong to?

Answer 9

family Togaviridae, genus Alphavirus - single stranded RNA

Question 10

what species of mosquito cause chikungunya?

Answer 10

Aedes spp - Aedes aegypti and Ae. albopictus

Question 11

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

Answer 11

2-6 days of illness

Question 12

what are other ways of transmission of chikungunya virus ?

Answer 12

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

Question 13

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

Answer 13

3-28%

Question 14

what is incubation period of chikungunya virus?

Answer 14

3-7 days (range 1-12 days)

Question 15

what are the symptoms of chikung?

Answer 15

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)

Question 16

what lab findings can you expect when you have chikingu?

Answer 16

increased creatinine and liver function tests, lymphopenia, thrombocytopenia

Question 17

what are the serious complications of chikingu?

Answer 17

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

Question 18

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

Answer 18

7-10 days

Question 19

what are the relapse symptoms of Chikung?

Answer 19

rheumatologic symptoms in months after acute illness

Question 20

how to diagnose Chikung?

Answer 20

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

Question 21

what is the vaccine for Chikung? age indication?

Answer 21

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

Question 22

what are the adverse reactions with IXCHIQ vaccine?

Answer 22

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

Question 23

precaution and contraindication of IXCHIQ vaccine?

Answer 23

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

precaution - pregnancy or breastfeeding

Question 24

what is coronavirus?

Answer 24

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

Question 25

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

Answer 25

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

Question 26

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

Answer 26

-50 years and older -immunocompromised -with certain underlying medical conditions -pregnant - preterm birth, stillbirth, or other pregnancy complications if infected while pregnant

Question 27

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

Answer 27

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

Question 28

what are the testings for Covd-19?

Answer 28

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.

Question 29

name the covid treatments available

Answer 29

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

Question 30

what virus cause dengue?

Answer 30

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

Question 31

which mosquitoes species transmit Dengue virus?

Answer 31

Aedes aegypti, Aedes albopictus

Question 32

how long does viremia last for dengue?

Answer 32

7 days - bloodborne transmission is possible

Question 33

is perinatal DENV transmission possible?

Answer 33

yes, near the time of birth

Question 34

where is dengue enedmic to?

Answer 34

tropics and subtropics - Puerto Rico, US Virgin Islands, US-affiliated Pacific Islands Sub-Saharan Africa, Latin America, Asia

Question 35

how many people are affected by Dengue per year?

Answer 35

>50 million cases

Question 36

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

Answer 36

urban and residential areas

Question 37

what % of DENV infections are asymptomatic?

Answer 37

40-80%

Question 38

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

Answer 38

5% or less

Question 39

what is the incubation period of Dengue?

Answer 39

5-7 days

Question 40

what are 3 phases of dengue?

Answer 40

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

Question 41

what are the symptoms of febrile phase of Dengue?

Answer 41

- 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

Question 42

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

Answer 42

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.

Question 43

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

Answer 43

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

Question 44

why is dengue in pregnancy more risky for infants?

Answer 44

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.

Question 45

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

Answer 45

0-7 days - nucleic acid amplification tests and IgM >7 days - IgM testing

Question 46

how long does IgM detected after dengue?

Answer 46

90 days

Question 47

which medications should be avoided when infected with dengue?

Answer 47

aspirin, NSADs, meds with anticoagulant properties

Question 48

how to treat dengue?

Answer 48

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

Question 49

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

Answer 49

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