Viral hemorrhagic fever

Question 1

Name the 3 types of viral hemorrhagic fever

Answer 1

Rodent-associated
Bat-associated
Arthropod-borne

Question 2

Which viral hemorrhagic fevers are transmitted by mosquitoes?

Answer 2

Yellow fever
Rift valley fever

Question 3

Which viral hemorrhagic fevers are transmitted by ticks?

Answer 3

Crimean congo fever

Question 4

Which viral hemorrhagic fevers are transmitted by rodents?

Answer 4

Lassa fever
Lujo fever

Question 5

Which viral hemorrhagic fevers are transmitted by bats?

Answer 5

Ebola
Marburg

Question 6

What are viral hemorrhagic fevers?

Answer 6

ssRNA viruses (easily killed by bleach)

Question 7

Are all viral hemorrhagic fevers notifiable conditions?

Answer 7

Yes! By law!

Question 8

Which VHFs have a vaccine?

Answer 8

Yellow fever
Rift valley fever (animals)

Question 9

Which VHFs have treatment?

Answer 9

Lassa fever
CCHF

Question 10

What is the differential diagnosis for VHF?

Answer 10

Bacterial septicemia
Rickettsia
Spirochete (leptospirosis)
Parasitic (malaria)
Viral (hepatitis)
Non-infective (drug reactions, snake bite)

Question 11

What are the 4 genera of filoviridae?

Answer 11

1. Marburgvirus
2. Dianlovirus
3. Cuevavirus
4. Ebola virus

Question 12

What are the 2 strains of Marburgvirus?

Answer 12

MARV (Uganda)
RAVN/RAAV (Kenya)

Question 13

What is the species of dianlovirus?

Answer 13

Mengla virus

Question 13

Which 2 viruses is mengla virus like phylogenetically?

Answer 13

Between Ebola and Marburg

Question 14

Is the actual disease-causing capability of menglavirus known?

Answer 14

No
New, from China, potential to be severe

Question 15

What are the species in cuevavirus?

Answer 15

Lloviu (LLOV) from Spain, France, Portugal

Question 16

Are cuevavirus pathogenic?

Answer 16

Only to bats
No human cases described

Question 17

What are the species of Ebolavirus?

Answer 17

Bundibugya (BDBV)
Sudan (SUDV)
Tai forest (TAFV)
Ebola (EBOV)

Question 18

How is ebolavirus transmitted?

Answer 18

Direct contact with human bodily fluids during acute illness

Question 19

Describe the pathogenesis of ebolavirus

Answer 19

1. Initial infection of MPS in regional lymph nodes
2. Replication, suppression of INF and rapid dissemination
3. Large cytokine and chemokine release
4. Endothelial permeability, macromolecular leakage, tissue destruction -> coagulopathy and hepatic dysfunction

Question 20

How are coagulation defects induced in ebolavirus infection?

Answer 20

Indirectly through host immune response

Question 21

What happens to platelets during filovirus infection?

Answer 21

Filovirus directly infect and destroy megakaryocytes

Question 22

What criteria is required to define ebola?

Answer 22

1. Travel from affected area <21d
2. Exposure to bodily fluids
3. Fever
4. Symptoms
5. Decreased platelets
6. Increased LFTs

Question 23

What are the 2 ebola vaccines?

Answer 23

Ervebo
Zabdeno and Mvabea

Question 24

How is lassa fever transmitted?

Answer 24

Direct contact with infected rodents or aerosols

Question 25

What is the incubation period of lassa fever?

Answer 25

3-16 days

Question 26

What is treatment of lassa fever?

Answer 26

Ribavirin MUST (max use of supportive therapy)

Question 27

How is CCHF transmitted?

Answer 27

Tick bites or direct contact with infected blood/tissue

Question 28

What is the incubation period of CCHF?

Answer 28

Tick (1-3d) Blood/tissue (5-6d)

Question 29

What is treatment of CCHF?

Answer 29

Ribavirin MUST

Question 30

What must you ALWAYS consider in acute febrile illness in young patients?

Answer 30

Meningococcemia

Question 31

Which virus is associated with "green monkey fever"

Answer 31

Marburg virus

Question 32

Which bats are a resevoir for marburgvirus?

Answer 32

Rousettus aegyptiacus

Question 33

What tests can be done for marburgvirus?

Answer 33

Blood/saliva PCR Serology

Question 34

How do you treat marburgvirus?

Answer 34

Monoclonal antibodies

Question 35

Is there a vaccine for marburgvirus?

Answer 35

Not technically Mvaboa vaccine produces 4 glycoproteins (zaira ebola, sudan, tai forest and marburg) but unproven

Question 36

How is dengue fever transmitted?

Answer 36

Aedes aegypti Aedes albopictus

Question 37

What is the clinical presentation of dengue according to WHO classification?

Answer 37

Dengue w/o warning signs Dengue w/ warning signs Severe dengue

Question 38

When is dengue fever highest risk for severity?

Answer 38

> 18 months apart from 1st infection

Question 39

What is the incubation of dengue fever?

Answer 39

3-14d

Question 40

What are the disease phases of dengue fever?

Answer 40

1. Febrile 2. Critical 3. Recovery

Question 41

What clinical test can be done for dengue?

Answer 41

Tourniquet test

Question 42

What are the clinical markers in dengue fever?

Answer 42

Low platelets Low white cells Elevated AST Synthetic liver dysfunction

Question 43

What are the 2 licensed dengue vaccines?

Answer 43

Dervaxia TAC-003 (QDENGA)

Question 44

What is the backbone of Dervaxia?

Answer 44

Yellow fever

Question 45

What is the backbone of QDENGA?

Answer 45

DENV-2

Question 46

Which vaccine does not require previous dengue exposure?

Answer 46

QDENGA