VIRAL INFECTIONS (based on Williams) Flashcards
What type of virus is the Mumps virus?
“RNA paramyxovirus”
How is the Mumps virus transmitted?
“Direct contact with respiratory secretions. saliva or fomites”
When is Mumps virus most transmissible?
“Before and within 5 days of parotitis onset”
What type of isolation is recommended for Mumps?
“Droplet isolation”
How is Mumps treated?
“Symptomatic treatment”
Does Mumps during pregnancy cause more severe disease?
“No. it is no more severe than in nonpregnant adults”
What is the main pregnancy risk associated with Mumps infection in the first trimester?
“Increased risk of spontaneous abortion”
Does Mumps cause congenital malformations?
“No.fetal infection is rare”
What prompted the recommendation of a third dose of MMR vaccine?
“Recent outbreaks in previously vaccinated young adults”
What type of vaccine is the MMR vaccine?
“Live-virus vaccine”
Is MMR vaccine safe during pregnancy?
“No. it is contraindicated in pregnancy”
How long should pregnancy be avoided after MMR vaccination?
“30 days”
Can breastfeeding women receive the MMR vaccine?
“Yes.breastfeeding is not contraindicated”
What type of virus is the Measles virus?
“Highly contagious RNA virus of the Paramyxoviridae family”
When do measles outbreaks typically occur in endemic areas?
“Late winter and early spring”
How is measles transmitted?
“Respiratory droplets”
What is the secondary attack rate of measles among susceptible contacts?
“>90%”
What are the typical symptoms of measles?
“Fever. coryza. conjunctivitis. cough”
What are Koplik spots?
“Small white lesions with surrounding erythema on the buccal mucosa”
Describe the measles rash.
“Erythematous maculopapular rash that starts on the face and spreads to the trunk and extremities”
How is acute measles infection diagnosed?
“Detection of measles-specific IgM antibodies in serum”
What additional test can confirm measles infection?
“RT-PCR testing of a throat swab. nasopharyngeal swab or urine specimen”
How is measles treated?
“Supportive care. evaluation for secondary infections”
What is the postexposure prophylaxis for measles in pregnant women without immunity?
“IVIG. ideally within 6 days of exposure”
What risks are associated with measles in pregnancy?
“Increased risk of pregnancy loss
What is the concern if a woman develops measles shortly before delivery?
“Risk of serious neonatal infection”
Is MMR vaccine provided during pregnancy?
“No. as it is a live-virus vaccine”
Should pregnancy be terminated if MMR vaccine was inadvertently given?
“No. MMR vaccination is not an indication for pregnancy termination”
When should susceptible women be vaccinated for measles?
“Routinely postpartum”
What type of virus causes Rubella?
“RNA togavirus”
How is Rubella transmitted?
“Nasopharyngeal secretions”
What is the transmission rate of Rubella to nonimmune individuals?
“80%”
When does Rubella peak in endemic areas?
“Late winter and spring”
What percentage of women are susceptible to Rubella?
“Up to 10%”
What is the incubation period for Rubella?
“12 to 23 days”
Describe the Rubella rash.
“Generalized maculopapular rash that begins on the face and spreads to the trunk and extremities”
What other symptoms are associated with Rubella?
“Arthralgias. arthritis. head and neck lymphadenopathy. conjunctivitis”
What percentage of Rubella infections are asymptomatic?
“25-50%”
How is Rubella diagnosed?
“Serological analysis for specific IgM and IgG antibodies”
What is a potential false-positive issue with Rubella IgM testing?
“Transient low levels of IgM can be detected in reinfection”
What is a key feature of congenital Rubella syndrome?
“Sensorineural deafness. cardiac defects. microcephaly. cataracts”
When is the highest risk for fetal effects from Rubella infection?
“First 12 weeks of gestation”
How is fetal Rubella infection diagnosed?
“Detection of Rubella virus by PCR in amniotic fluid”
What is the recommended prevention strategy for Rubella?
“MMR vaccination for non-pregnant women of childbearing age”
How long should pregnancy be avoided after MMR vaccination?
“1 month”
What type of virus is Parvovirus B19?
“Single-stranded DNA virus”
What disease does Parvovirus B19 cause?
“Erythema infectiosum (fifth disease)”
How is Parvovirus B19 transmitted?
“Respiratory secretions. blood transfusion. organ donation”
When does Parvovirus B19 infection most commonly occur?
“Late winter to early spring”
What is the classic rash of Parvovirus B19 in children?
“Slapped-cheek appearance”
What fetal complications are associated with Parvovirus B19?
“Nonimmune hydrops. fetal anemia. stillbirth”
What percentage of fetal infections occur in maternal Parvovirus B19 infection?
“Up to one-third”
How is fetal anemia due to Parvovirus B19 detected?
“MCA Doppler ultrasound”
What is the treatment for severe fetal anemia due to Parvovirus B19?
“Fetal blood sampling and intrauterine transfusion”
What are potential long-term effects of Parvovirus B19 fetal infection?
“Neurodevelopmental impairment in some cases”
Is there a vaccine for Parvovirus B19?
“No. no vaccine is available”
What are the main respiratory viruses causing the common cold?
“Rhinovirus. adenovirus. enterovirus. common coronavirus”
What virus is associated with acute flaccid myelitis in children?
“EV-D68 enterovirus”
What is the most frequently identified virus in amniotic fluid PCR testing?
“Adenovirus”
What is the major risk of adenoviral infection in pregnancy?
“Fetal myocarditis. nonimmune hydrops”
What group of viruses does Coxsackievirus belong to?
“RNA Picornavirus”
What are symptoms of Coxsackievirus infection?
“Aseptic meningitis. polio-like illness. hand-foot-mouth disease. myocarditis”
What is the risk of maternal Coxsackievirus infection for the fetus?
“Transplacental passage. neonatal myocarditis. pneumonia. encephalitis”
How is Poliovirus transmitted?
“Fecal-oral route”
What severe disease does Poliovirus cause?
“Paralytic poliomyelitis”
Is Polio vaccine recommended in pregnancy?
“Inactivated polio vaccine is recommended if at risk”
Is the live oral Polio vaccine safe in pregnancy?
“Has been used in mass vaccination without fetal harm”
What type of virus is West Nile Virus?
“RNA flavivirus”
What is the most common arthropod-borne disease in the United States?
“West Nile Virus”
How is West Nile Virus transmitted?
“Mosquito bites (rarely through donated blood or organs)”
What is the incubation period of West Nile Virus?
“2 to 14 days”
What percentage of West Nile Virus infections are asymptomatic or mild?
“Most cases”
What severe complications can occur in less than 1% of West Nile Virus infections?
“Meningoencephalitis or acute flaccid paralysis”
What are the symptoms of severe West Nile Virus infection?
“Fever. mental status changes. muscle weakness. coma”
How is West Nile Virus diagnosed?
“Detection of viral IgG and IgM in serum. IgM in cerebrospinal fluid”
What is the treatment for West Nile Virus?
“Supportive care (no effective antiviral treatment)”
What is the primary prevention strategy for West Nile Virus in pregnancy?
“Use of insect repellant containing DEET”
What environmental measures help prevent West Nile Virus exposure?
“Avoiding outdoor activity. stagnant water. wearing protective clothing”
What are the possible fetal effects of maternal West Nile Virus infection?
“Unclear. but case reports suggest possible chorioretinitis and cerebral leukomalacia”
Does maternal West Nile Virus infection increase risk of miscarriage or congenital malformations?
“No. per West Nile Virus Pregnancy Registry data”
Is maternal West Nile Virus infection harmful to a breastfeeding infant?
“No evidence suggests harm”
What type of virus is Zika Virus?
“RNA flavivirus”
How is Zika Virus transmitted?
“Mosquito bite (also sexual transmission)”
How long can Zika Virus persist in body fluids?
“Months after acute infection”
When was Zika Virus first introduced to the Americas?
“2014. in Brazil”
As of 2020, what is the status of Zika transmission?
“No countries reported active Zika transmission”
What percentage of adults with Zika infection are asymptomatic?
“Approximately 80%”
What are the common symptoms of Zika infection?
“Mild rash. fever. headache. arthralgia. conjunctivitis”
Can asymptomatic maternal Zika infection affect the fetus?
“Yes. severe fetal infection can occur”
What is the fetal mortality rate in symptomatic Zika-positive pregnant women?
“7% in one study”
What is the risk of birth defects in first-trimester Zika exposure?
“5 to 15%”
What are the features of congenital Zika syndrome?
“Microcephaly. lissencephaly. ventriculomegaly. intracranial calcifications. ocular abnormalities. congenital contractures”
When is Zika virus typically detectable in maternal blood?
“Around symptom onset. may persist for months in pregnancy”
When do Zika IgM antibodies become detectable?
“Within the first 2 weeks of infection”
What laboratory tests are recommended for symptomatic pregnant women with possible Zika exposure?
“PCR testing of serum and urine for Zika and dengue RNA”
What tests are recommended for pregnant women with ultrasound findings of congenital Zika syndrome?
“Zika virus PCR and IgM on serum and urine”
Can amniotic fluid PCR diagnose congenital Zika infection?
“May be performed. but diagnostic accuracy is unclear”
Is there a treatment or vaccine for Zika virus?
“No specific treatment. vaccines are in development”
What are key prevention strategies for Zika virus?
“Mosquito control. DEET use. avoiding sexual contact with exposed partners”
What type of virus is Ebola Virus?
“RNA Filovirus”
How is Ebola Virus transmitted?
“Direct person-to-person contact”
What are the main clinical features of Ebola Virus disease?
“Severe hemorrhagic fever. immunosuppression. disseminated intravascular coagulation”
What is the treatment for Ebola Virus?
“Supportive care”
What is the maternal mortality rate for Ebola Virus disease?
“Approximately 50%”
What are the fetal and neonatal outcomes in maternal Ebola Virus infection?
“Universally poor outcomes”
Are pregnant women more susceptible to Ebola Virus infection?
“No evidence suggests increased susceptibility”
Where can persistent Ebola Virus be detected in survivors?
“Sanctuary sites (eyes. gonads)”
What is the name of the approved Ebola vaccine?
“rVSV-ZEBOV”
When was rVSV-ZEBOV approved in the United States?
“2019”
Does rVSV-ZEBOV vaccination in early pregnancy cause pregnancy loss or congenital anomalies?
“No association found”
