Viral Hemorrhagic Fever 87-88 Flashcards
1
Q
VHF caused by 4 viral families
A
Flaviviridae, Bunyaviridae, Arenaviridae, Filoviridae
2
Q
Transmission of VHF
A
Arthropod Vector, Rodent Excretions
3
Q
VHF Clinicopathological features
A
Fever Hemorrhagic manifestations Thrombocytopenia Shock Neurological disturbances
4
Q
VHF Signs and sxs
A
Fever Fatigue Dizziness Muscle aches Loss of strength Exhaustion
5
Q
Serious VHF conditions
A
bleeding under skin
interal organs
body orifices
6
Q
Sever Ill VHF
A
renal fail, shock nervous system coma delirium seizures
7
Q
What does the virus infect?
A
Tissue macrophages
Dendritic Cells
8
Q
VHF effect on dendritic cell
A
reduce costimulatory molecules
↓ immune responses
9
Q
Hemorrhagic complications of VHF
A
Hepatic Damage
Consumptive coagulopathy
Thromboctopenia
10
Q
Flavivirday
A
\+ RNA Enveloped glycoproteins Structural Non Structural coding regions NS1 antigen
11
Q
Bunyaviridae
A
- RNA Enveloped Gn Gc proteins in envelope L segment M segment S segment
12
Q
Arenaviridae
A
Ambisense ssRNA
Enveloped
Segmented
13
Q
Filoviridae
A
- ssRNA
Filamentous
Pleomorphic
Enveloped
14
Q
Types of Flaviviruses
A
West Nile
St Louis
Dengue
Yellow Fever
15
Q
Dengue
A
4 serotypes
16
Q
Dengue Host
A
Primate
But now humans by accident
17
Q
Transmission of Dengue
A
Aedes mosquito — arbovirus
18
Q
Clinical of Dengue
A
- DF
2. DHF
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
20
Q
DHF
A
infection from 2nd dengue Recurrent Fever Hemorrhgic manifestations positive tourniquet Thrombocytopenia Plasma leakage Pleural effusion
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
22
Q
Dengue Immunity
A
IgM 3-5 days
IgG shortly after
accumulation of complexes= tissue damage
NO CROSS IMMUNITY BETWEEN STRAINS
23
Q
Yellow Fever Two Strains
A
Dakar
17D
24
Q
yellow Fever Host & Vectors
A
Primate Humans (similar to Dengue) Mosquito (Vector) Aedes Haemagogus Sabethes
25
Yellow Fever Clinical
```
Biphasic
Acute
• fever
• HA
• LOA
• shivers, skin flushing red eyes
Toxic
• return of fever
• jaundice, GI Hemorrhage
• Dissemination: Kidneys Heart, Vasculature
```
26
YF Pathogenesis
attacks Kupfer cells & Hepatocytes
| •Councilman bodies
27
YF Immunity
Similar to Dengue Virus IgM IgG
YF VAX- 17D strain
Boosters NOT required
28
Bunyviruses L segment
RNA dep RNE polymerase
29
Bunyvirus M Segment
Gn & Gc glycoproteins
30
Bunyvirus S Segment
Nucleoprotein
31
Bunyvirus 4 main genera
1. orthobuny
2. phlebovirus - VHF
3. Nairovirus- VHF
4. Hantavirus- VHF, no arbovirus
32
Phlebovirus
Rift Valley Virus
33
NairoVirus
Crimean-Congo hF
34
Hantavirus
Hantaan virus
35
Rift Valley
E and S africa
36
Rift Valler Trasmission
```
Mosquito vector
1. aedes
2. culex
3. Erethmapodites
ALSO BY CONTACT
```
37
Rift Valley Clinical
Human
• asymptomatic, fever liver, MIMIC INFLUENZA
• Hemorrhagic fever
• Blindness reported
38
Rift Pathogenesis
Replication at the site bite
• reticulo endothelial system
• Viremic Spread
39
Rift Valley Fever immunity
Recoverd= long lasting immune
| No commercially available vaccines
40
Hataan Virus Epidemiology and Reservoir
CHINA, RUSSIA, KOREA
Striped Field Mouse
Rodent Born
41
Hataan Clinical Features
Hemorrhagic Fever w/ Renal Syndrome
blurred vision
petechiae, purpura, subconjuctival
Thrombocytopenia
42
Late Clinical Hataan
Shock
Renal dysfunction
Edema
Low Blood Pressure
43
Hataan Virus pathogenesis
Same as rift valley, but NO ARTHROPOD
| RODENT ONLY
44
Crimean Congo HF Epidemiology
SE Europe, Asia & Africa ( BIOTERROISM )
45
CCHF Resorvoir & Vector
Reservoir and Vector = TICK hyalomma marginatum
| Humans infected by tick bite or CONTACT w/ infected animal
46
CCHF Clinical Features
```
Fever
Headache
back/joint pain
Vomiting
Flushing
Red Eyes
```
47
Late Clinical CCHF
Hemorrhages, Petechiae, purpura, sub conj, mucosal membranes
P. Edema
hepatitis
Liver and Kidney Failure
48
CCHF Pathogenesis
Similar to Dengue, replication at tick site, viremia, spread to other organs
49
Arenavirus Segments
L segment
| S Segment
50
Arena L segment
Polymerase
| Z Protein
51
Arena S Segmetn
N protein
| GPC precursor
52
Arenaviridae - Virus
LASSA Virus
53
Lassa Virus Epidemiology & Reservoir
```
Nigeria, W Africa
Multimammate Rat
Ingestion w/ animal urine
Direct contact animals
person 2 person
```
54
Lassa clinical Features
```
Initial symptoms
Fever
Malise
retrosternal pain
nausea
```
55
Sever Clinical Lassa
```
Exhaustion
Edema
Neurologic
Hemorrhagic
Multiple organ necrosis
Shock
```
56
Lassa Pathogenesis
```
Inoculation
Inhalation
Ingestion
Macrophage & Endothelia Receptor Med Endocytosis
virus replication inflammatory mediators
viremic spread
```
57
Filovirus Simple Genome Codes
```
Viral glycoprotein
Polymerase
Nucleoprotein
Transcription factor
matrix and membrane proteins
```
58
Filoviridae Genera
Ebolavirus
| Marvurgvirus
59
Marburg Virus Epidemiology and Reservoir
German, Endemic in Africa
| Fruit Bats the reservoir
60
Ebola Virus Epidemiology and subtypes
```
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
Filoviruses Clinical
```
Fever
headache
Fatigue
Diarrhea/vomiting
sno appetite
unexplained vledding
joint & muscle aches
THROMBOCYTOPENIA
```
62
Filoviruses Pathogenesis
```
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
Diagnosis VHF
Epidemiologic Factors
Seroogical Tests
PCR and virus isolation
Lab findings
64
Treatment
```
Suppotive care
Ribvirin-- Lassa, hantaan and RVF
Ebola
• convalescent plasma
• ZMapp
• TKM- Ebola: siRNAs
Prevention: Control
```
