Viral Hemorrhagic Fever 87-88 Flashcards

1
Q

VHF caused by 4 viral families

A

Flaviviridae, Bunyaviridae, Arenaviridae, Filoviridae

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2
Q

Transmission of VHF

A

Arthropod Vector, Rodent Excretions

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3
Q

VHF Clinicopathological features

A
Fever
Hemorrhagic manifestations
Thrombocytopenia
Shock
Neurological disturbances
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4
Q

VHF Signs and sxs

A
Fever
Fatigue
Dizziness
Muscle aches
Loss of strength
Exhaustion
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5
Q

Serious VHF conditions

A

bleeding under skin
interal organs
body orifices

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6
Q

Sever Ill VHF

A
renal fail,
shock
nervous system
coma
delirium
seizures
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7
Q

What does the virus infect?

A

Tissue macrophages

Dendritic Cells

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8
Q

VHF effect on dendritic cell

A

reduce costimulatory molecules

↓ immune responses

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9
Q

Hemorrhagic complications of VHF

A

Hepatic Damage
Consumptive coagulopathy
Thromboctopenia

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10
Q

Flavivirday

A
\+ RNA
Enveloped 
glycoproteins
Structural 
Non Structural coding regions
NS1 antigen
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11
Q

Bunyaviridae

A
- RNA
Enveloped
Gn Gc proteins in envelope
L segment
M segment
S segment
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12
Q

Arenaviridae

A

Ambisense ssRNA
Enveloped
Segmented

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13
Q

Filoviridae

A
  • ssRNA
    Filamentous
    Pleomorphic
    Enveloped
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14
Q

Types of Flaviviruses

A

West Nile
St Louis
Dengue
Yellow Fever

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15
Q

Dengue

A

4 serotypes

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16
Q

Dengue Host

A

Primate

But now humans by accident

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17
Q

Transmission of Dengue

A

Aedes mosquito — arbovirus

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18
Q

Clinical of Dengue

A
  1. DF

2. DHF

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19
Q

DF

A
acute infection
high fever plus 2 of following
headache
eye pain
joint pain
muscle pain
rash
mild bleeding
low WBC
RESOLVES 2 WEEKS
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20
Q

DHF

A
infection from 2nd dengue
Recurrent Fever
Hemorrhgic manifestations
positive tourniquet
Thrombocytopenia
Plasma leakage
Pleural effusion
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21
Q

DHF Pathogenesis

A
Non-neutralizing abs promote uptake by
1. macrophages
2. Monocytes
3. Dendritic Cells
Activate Tm cells, 
Effector T Cells release inflammatory vasoactive
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22
Q

Dengue Immunity

A

IgM 3-5 days
IgG shortly after
accumulation of complexes= tissue damage
NO CROSS IMMUNITY BETWEEN STRAINS

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23
Q

Yellow Fever Two Strains

A

Dakar

17D

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24
Q

yellow Fever Host & Vectors

A
Primate
Humans (similar to Dengue)
Mosquito (Vector)
Aedes
Haemagogus
Sabethes
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25
Q

Yellow Fever Clinical

A
Biphasic
Acute
• fever
• HA
• LOA
• shivers, skin flushing red eyes
Toxic
• return of fever
 • jaundice, GI Hemorrhage
• Dissemination: Kidneys Heart, Vasculature
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26
Q

YF Pathogenesis

A

attacks Kupfer cells & Hepatocytes

•Councilman bodies

27
Q

YF Immunity

A

Similar to Dengue Virus IgM IgG
YF VAX- 17D strain
Boosters NOT required

28
Q

Bunyviruses L segment

A

RNA dep RNE polymerase

29
Q

Bunyvirus M Segment

A

Gn & Gc glycoproteins

30
Q

Bunyvirus S Segment

A

Nucleoprotein

31
Q

Bunyvirus 4 main genera

A
  1. orthobuny
  2. phlebovirus - VHF
  3. Nairovirus- VHF
  4. Hantavirus- VHF, no arbovirus
32
Q

Phlebovirus

A

Rift Valley Virus

33
Q

NairoVirus

A

Crimean-Congo hF

34
Q

Hantavirus

A

Hantaan virus

35
Q

Rift Valley

A

E and S africa

36
Q

Rift Valler Trasmission

A
Mosquito vector
1. aedes
2. culex
3. Erethmapodites
ALSO BY CONTACT
37
Q

Rift Valley Clinical

A

Human
• asymptomatic, fever liver, MIMIC INFLUENZA
• Hemorrhagic fever
• Blindness reported

38
Q

Rift Pathogenesis

A

Replication at the site bite
• reticulo endothelial system
• Viremic Spread

39
Q

Rift Valley Fever immunity

A

Recoverd= long lasting immune

No commercially available vaccines

40
Q

Hataan Virus Epidemiology and Reservoir

A

CHINA, RUSSIA, KOREA
Striped Field Mouse
Rodent Born

41
Q

Hataan Clinical Features

A

Hemorrhagic Fever w/ Renal Syndrome
blurred vision
petechiae, purpura, subconjuctival
Thrombocytopenia

42
Q

Late Clinical Hataan

A

Shock
Renal dysfunction
Edema
Low Blood Pressure

43
Q

Hataan Virus pathogenesis

A

Same as rift valley, but NO ARTHROPOD

RODENT ONLY

44
Q

Crimean Congo HF Epidemiology

A

SE Europe, Asia & Africa ( BIOTERROISM )

45
Q

CCHF Resorvoir & Vector

A

Reservoir and Vector = TICK hyalomma marginatum

Humans infected by tick bite or CONTACT w/ infected animal

46
Q

CCHF Clinical Features

A
Fever
Headache
back/joint pain
Vomiting
Flushing
Red Eyes
47
Q

Late Clinical CCHF

A

Hemorrhages, Petechiae, purpura, sub conj, mucosal membranes
P. Edema
hepatitis
Liver and Kidney Failure

48
Q

CCHF Pathogenesis

A

Similar to Dengue, replication at tick site, viremia, spread to other organs

49
Q

Arenavirus Segments

A

L segment

S Segment

50
Q

Arena L segment

A

Polymerase

Z Protein

51
Q

Arena S Segmetn

A

N protein

GPC precursor

52
Q

Arenaviridae - Virus

A

LASSA Virus

53
Q

Lassa Virus Epidemiology & Reservoir

A
Nigeria, W Africa
Multimammate Rat
Ingestion w/ animal urine
Direct contact animals
person 2 person
54
Q

Lassa clinical Features

A
Initial symptoms
Fever
Malise
retrosternal pain
nausea
55
Q

Sever Clinical Lassa

A
Exhaustion
Edema
Neurologic
Hemorrhagic
Multiple organ necrosis
Shock
56
Q

Lassa Pathogenesis

A
Inoculation
Inhalation
Ingestion
Macrophage & Endothelia Receptor Med Endocytosis
virus replication inflammatory mediators
viremic spread
57
Q

Filovirus Simple Genome Codes

A
Viral glycoprotein
Polymerase
Nucleoprotein
Transcription factor
matrix and membrane proteins
58
Q

Filoviridae Genera

A

Ebolavirus

Marvurgvirus

59
Q

Marburg Virus Epidemiology and Reservoir

A

German, Endemic in Africa

Fruit Bats the reservoir

60
Q

Ebola Virus Epidemiology and subtypes

A
Endemic to Africa
1. Zaire
2. Sudan
3. Tai Forest
4. Bundibugyo
5. Reston 9 no disease if infected )
same mode of transmission as Marburg
61
Q

Filoviruses Clinical

A
Fever
headache
Fatigue
Diarrhea/vomiting
sno appetite
unexplained vledding
joint & muscle aches
THROMBOCYTOPENIA
62
Q

Filoviruses Pathogenesis

A
replicate w/ macrophages and dendritic
virus induced suppression of Type I ifn
IMPAIRED Adaptive immunity
lymphocytes apoptosis ( not infected )
cytokines systemic inflammation
hepatocellular necrosis
vascular leakage
63
Q

Diagnosis VHF

A

Epidemiologic Factors
Seroogical Tests
PCR and virus isolation
Lab findings

64
Q

Treatment

A
Suppotive care
Ribvirin-- Lassa, hantaan and RVF
Ebola
• convalescent plasma
• ZMapp
• TKM- Ebola: siRNAs 
Prevention: Control