Viral infections of the respiratory tract Flashcards
describe the symptoms typically associated with the common cold and how they differ from lower respiratory tract infections
headache, nasal discharge, sore throat, nonproductive cough
which viruses typically cause the common cold?
rhinovirus (most common)
coronavirus
which viruses cause more serious respiratory tract infections?
human respiratory syncytial virus
parainfluenza virus
what is the epidemiology of SARS (stats, animal reservoir, severity, fatality rate)?
stats - 8000 cases Feb-June 2003
likely animal reservoir - bats
severity - most require hospitalization
fatality rate - 10%
what is the symptomology of SARS?
fever cough SOB pneumonia ARDS
what is the epidemiology of MERS (stats, animal reservoir, severity, fatality rate)?
stats - 1618 cases Sept 2012-Nov 2015
likely animal reservoir - camels
severity - asymptomatic to ARDS
fatality rate - 36%
what is the symptomology of MERS?
fever cough SOB pneumonia ARDS
what are the typical symptoms associated with influenza?
fever myalgia headache shaking chills cough 3-5 days
what are the 4 main patient groups associated with increased risk for influenza complications
- children younger than 2
- adults 65 and older
- pregnant women and women 2 wk postpartum
- persons with medical conditions
how are the 4 influenza antiviral agents similar?
oseltamivir and amantadine / rimantadine are both oral
how are the 4 influenza antiviral agents different?
zanamivir and oseltamivir: both neuraminidase inhibitors, for influenza A and B
amantidine and rimantidine: adamantanes, for influenza A (M2 protein)
zanamivir: only inhalation medication
what are the differences between bacterial pneumonia following influenza and primary influenza pneumonia (etiology, symptoms, average onset, sputum gram stain, chest radiograph, prognosis)?
bacterial pneumonia following influenza:
etiology - bacterial respiratory pathogens
symptoms - biphasic pattern
average onset - 7 days post symptoms
sputum gram stain - S. pneumo, S. aureus, H. influenza
chest radiograph - depends on etiologic agent
prognosis - depends on etiologic agent
primary influenza pneumonia etiology - influenza virus (A) symptoms - progressive worsening average onset - 1-4 days post symptoms sputum gram stain - abundant PMN w/o bacteria chest radiograph - usually interstitial prognosis - 50% mortality
what are the characteristics of the three categories of influenza vaccines (agent, administration, eligible patients)?
inactivated influenza vaccines (IIV):
formalin inactivated
IM / ID
over 6 mo (IM); 18-64 yo (ID)
live attenuated influenza vaccine (LAIV):
attenuated
intranasal
healthy non-pregnant 2-49 yo
recombinant influenza vaccine (RIV):
hemagluttinin protein
IM
18-49 years
what are the symptoms associated with CMV pneumonitis?
spiking fever malaise, lethargy, myalgia, arthralgia pneumonitis leukopenia hepatitis thrombocytopenia GI symptoms correlated with graft vs host disease
what are the different presentations for CMV infection?
immunocompetent - asymptomatic or mono-like illness
immunocompromised - CMV pneumonitis / gastritis (transplant), CMV retinitis (HIV)
neonates - cytomegalic inclusion disease
what are the routes of transmission of cytomegalovirus?
intrauterine - 1% perinatal postnatal blood transfusion (1-5%) organ transplant ( 60-80% positive to negative)
which antivirals are used to treat CMV?
ganciclovir
valganciclovir
cidofovir
foscarnet (for resistance)
what is the respiratory disease associated with HSV?
pneumonitis
what is the respiratory disease associated with VZV?
chicken pox can spread to the lungs
secondary bacterial infections
what is the respiratory disease associated with EBV?
infectious mononucleosis
what is the contagious period of influenza patients?
1 day prior to symptoms to 5-7 days post
what kind of vaccine is flucelvax? what is the dose?
cell culture based vaccine; produced in the madin darby canine kidney (MDCK) cell line
standard dose
what kind of vaccine is fluzone? what is the purpose? what is the dose?
inactivated, available for adults over 65 to increase efficacy of immune response
high dose
what kind of vaccine is flublok? what is significant about it?
recombinant HA produced in insect cells
egg free
