viral gastroenteritis Flashcards

1
Q

viruses are..

A

obligate IC pathogens

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2
Q

viruses infect ??

thereby messing up ??

causing what type of diarrhea ??

A

enterocytes in the villi of the sm. intestine

disrupting both digestive and absorptive functions

osmotic diarrhea from inability to digest disaccharides

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3
Q

viruses transmitted via

A

fecal-oral route, but food and water can be major vehicles

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4
Q

virus clinical features

fever?

A

vomiting, diarrhea, abdominal pain
fever
some (norwalk, norovirus): ha and myalgias

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5
Q

virus dx

A

immunoassay or electron microscopy: RT-PCR (for Norovirus)

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6
Q

virus tx

A

supportive, fluid replacement (esp infants)

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7
Q

virus: vaccines?

A

for Rotavirus:
Tetravalent Rhesus Rotavirus-based Reassortant Live Oral Vaccine (RV-TV, Rotateq -Merck)

Wyeth’s vaccine no longer used: intussusception

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8
Q

virus prevention

A

soap and water > etOH hand san (Norovirus)

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9
Q

Rotavirus

A

dsRNA, segmented genome, serotypes (A* (US),B,C)

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10
Q

rotavirus vir. factor

A

enterotoxin NSP4: nonstruc. glycoprotein (diff. rec. w. age)

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11
Q

rotavirus immunogenic component of vaccine

A

G glycoprotein (G1-G4)-tetravalent also used to serotype virus

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12
Q

most common cause of sev. diarrhea in infants and young kiddos

A

rotavirus

(maj. cause infant mort., 3% hospitalizations

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13
Q

how is rotavirus spread?

can last for days-weeks where?

A
person-person
-asymptomatic carriage is important
on surfaces (changing diapers)
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14
Q

is rotavirus low or high dose organism?

A

LOW! mountain range–propagated

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15
Q

rotavirus presentation

how long?

A

dehydrating diarrhea, vomiting, fever, abd pain
5-7 days
(use BRAT diet)

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16
Q

norovirus

evolving?

A
ssRNA small, round, structured virus 
7 genogroups (30 genotypes) 
new pandemic strain emerges every 2-4 yrs!
17
Q

noroviruses recognize..

A

histo-blood group Ags in strain-sp. manner

ABO, Lewis and secretor families involved in norovirus binding

18
Q

this gene ??? is determines susc. to norovirus infection

A

fucosyltransferase 2 (FUT2) gene

19
Q

ppl with this trait ?? are resistant to norwalk virus

A

nonsecretors (20% Europeans)

20
Q

norovirus shares characteristics with

A

norwalk virus

21
Q

most common cause of infectious GE in all ages?

responsible for 50% of ??
80% of non-food-borne outbreaks occur where ???

A
norovirus
also universal among children
all food-borne GE outbreaks in US
nursing homes, long-term care settings
also hospitals
22
Q

setting for 2/3 of norovirus FB outbreaks?

A

restaurants, then banquet and catering sites

23
Q

1% non-food borne norovirus outbreaks attrib. to

A

cruise ships

24
Q

norovirus: low or high dose?

spread how??

A
low (10 virions)
spread aerosolized (vomit)
25
what virus resistant to chlorination and freezing and persists in the environment
norovirus
26
norovirus inf individuals are highly contagious for how long?? virus can be shed up to ?? post recovery
72 hrs post recovery (3 days) 2 wks
27
norovirus immunity last ??
2-3 yrs
28
norovirus onset?
12-48 hr incubation period (1/2 day to 2 days)
29
norovirus presents with ?? how long??
epidemic vomiting syndrome: acute vomiting*, diarrhea, *fever (low-grade), myalgia, ha 1-2 days
30
Kaplan's criteria for dx viral GE outbreak
1. mean/median illness duration of 12-60 hrs (0.5-2.5 days) 2. mean/median incubation period of 24-48 hrs (1-2 days) 3. >50% ppl with vominting 4. no bac agent previously found
31
norovirus dx
RT-PCR
32
Norwalk virus
ssRNA; 2 serotypes
33
norwalk virus causes what ?? in who?? but...
epidemics of vomiting and diarrhea older children in adults all ages are affected
34
norwalk virus occurs when?? associated with ??
summer shellfish, other food, water is a common vehicle
35
Norwalk virus occurs in what groups?
community-wide outbreaks, families | nursing homes
36
norwalk virus presentation | duration?
acute vomiting, diarrhea, *fever*, *myalgia and ha* | 1-2 days
37
enteric adenovirus causes what in who ?? seasonality??
dsDNA enteric diarrhea of infants and young children no seasonality here
38
enteric adenovirus presentation | duration
prolonged diarrhea *5-12 days* vomiting and fever