Viral menigitis and poliomyelitis Flashcards
بسم الله الرحمن الرحيم
وهو علي كل شئ قدير
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aseptic meingits mean ?
Mengigeal inflammation with sterile CSF without bacteria
Most common form of meneigits is,,,,,,,
Except chidlern younger than 10 years the ,,,,,, is more
Midle than bacterial and funal menigits
causes Skin rashes ,sore thorats and colds
VIRAL
BACTERIAL
Symptoms of menigitis
=Fever
=Altered consicusness irritability photophobia
=Seizure
=Bugling fonatnels
=Stiff neck or nuchal rigidity
=Meningisumus (stiff neck + Brudzinski and Kernig signs )
The most commoc causes of viral menigitis ?
Enteroviruses ( coxasackie and echovirus )
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less commn :
HSV
VZV
CMV
2M Mumpes measels
West Nile virus HIV
HEPRS SIMPLEX TYPE2
Enceloped
duble stranded DNA virus
transmitted sexully
semin and vaginal discharge
from mother to fetus
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VZV
Enveloped Double stranded DNA VIRUS
Tranismitted by droplets of resp secretion
contact with vesicular fluid of rash in chicken pox or zoster
Mumps
Enveloped single stranded RNA
Droplets and Saliva
west nile virus
arbovirus
enveloped Single stranded RNA virus transmitted by?
arthtopds vector
HIV
enveloped RNA Virus
can be transmitted through blood and blood product
ans seexual process
Enteroviruses belongs to ,,,,,,,
4 sub groups
PCEN
Non enevloped single stranded +snese RNA virus with icosahedral symmetrty
Unllikde rhinovirsues they are ?
Enter through ?>
PicoRnaVirdiae
Polioviruses
Coxsackiviruses
Echovirsues
Newer enteroviruses
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HCL acid stable
GIT
what are enetrovirus mode of tramsnossion
Aerosol inhalation
ingestion then to orophaynx replicating to reach peyers pathces then to blood
primary viremia
secondary viremia
then to CNS tropism
and tropism to other systems
pleurosy myocarditis skin rash other !
Non polio enteroviruse mor common in ,,,, and,,,,,,,
Spread
1-
2-
3-
4-
The only ressvoir is ?
Respiratory aerosols plays a role in ,,,,,, virus transmission
summer and fall
person to person
House flies
waste water and sweage
fecal oral transmisson
Human
Coxacike virus
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tip:rhino virus die in gastric acidity
90 most aseptic menigitis by?
Group B coxackie virus
Echoviruses
Diagnosis of meniegit by?
Lumbar puncture
for CSF analysis
supranant
normal protien glucose and pressurre but high lymphocyte this is viral etiology
specific method for promet diagnosius of viral menigits
PCR
Reverse trancriptase PCR
LAB DIAGNOIIS OF VIRAL MENIGITS
CSF evaluation
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PCR
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Virus isolation
Serology
Neutaliztion tests or EIA are used
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How to prevent viral menigits ?
no antiviral due to muilplicity of serotypes
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GOOD HYGIENE PRACATICE
Clean hands
claean surfaces
coveing cough
avoid kissing or sharing glass or items of eating
Viral menigits dagner?
less fulminant than bacterial menigits
but in infants <1 years causes speech and language delay
Polioviruses has serotypes accoirding to outer ,,,,proteins
1-3
Reaction to physical and chemical agents inactivated by?
1-
2-
3-
)))))))))))))))
enteroviruses are transient inhibtants of human alimnetary tracts they are acid .,,,,,,,,? can be isolated from ,,,,oir,,,,,,,,
all are traenimistted by ? and frow at ?
capsid
1-heating
2-pasteruiztaton
3-cholorination
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stable
Throat or lower intestin
Feco oral transmisson at 36-37 degress
Purely neurotropic virus
Poliomyelits
Polio
natural cases ocuuri only in man
source from ,,,and,,,cases
incubation =
apparent and subclinical patients
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7-14 days
3-35 day
abortive poliomyelitis
the immune system succeed in aboring poilio infecton of CNS
by netraulizing antibodeis aborting it once entering the Blood from intesitn peyrs patches
If in rare cases poliovirus reached Blood what happen
spread thorugh perihperal nerves to the anterior horn cells of spinal cord leading to paralytic poliomyelitis
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Poliovirus and tonsillectomy
The poliovirus after tonsillectomy spread thorugh cut nerve fibers of orophayenx then to CNS
Steps of pathogenisis of Polioviruses
1-Alimentary phase
2-Lymphatic phase
3-Viremic phase if no abortive poliomyeltis
4-Neurological phase
Clinical findings of poliomyelitis
Asymtomatic
Abortive poliomyelits
with fever heache nasuse vomiting constipation
Non paralytic poliomyelitis
paralytic poliomyelits
Laboratory diagnosis of polioviruses
Isolation of virus by throat swab or rectal swab
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Seology L
Rising titre in ELISA+ Neutralization test
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no antiviral + symptomatic treatment + resp support
prevnetion of Poloivirsurs
1-avoid fecoral contamination
2-avoid operation in feverish childs
3-Gamma globulins protect agains paralytic disease befroe infection or before Nervous lesion
4-Vaccines
Vaccines of poliomyelits
Oral poliovaccine live attenuated 3 serotypes most effective due to IgA IgG IgM
Inactivated polio vaccine IPV 3 formalin killed polio serotypes
Sabin vaccine is ?
Iive attenuated ,,,,,,,,,,,, stabilized
containing ,,,,,,,,,,,,,,,,,,,,,grown in human or monkey diploid cell cultures . it can be kept at 4c for a year
aminstered easily by,,,,,,,,,,,,
Mass vaccination how ?
Live attenutaed virus shed in stool of immunized children so person exposed to ,,,,,,,,,,,,,,,,,,,,,,, of vaccinated children may be exposed and infected with live attenuated vaaccine cuasing?
Magnusim choloride
3 poliovirus strains
oral droplets
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Fecal material
Herd immunity
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tips :
higly effecitve eliciting immunity to polios
50 immunity after 1 dose
95 immunity after 3 doses
Immunity probably life lonog
Mention advantages of OPV
HLPE2
eFfictevenss
Life long with no need to boosters mostly
Eliciting Local immunity IgA and systemic immunity by IgG
Ease of adminstraion
Possibility of attenuated virus cirulating in community by spread to contacts indirect immunizatioon or Herd Immunity
Disafvantage of OPV ?
BMP
Mutation into More virulent strain
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Blocked if another enterovirus invading cells
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trasnmitted to others with mutation !
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Associated poilomyeleitis if Mutated
Mention advanatges of IPV
-Cannot undergo genetic -virulence -so no associated diesease
-Saftery transport and storage
-safety adminsterd in immunodefecits
Mention disavnatege of IPV
Lack of local gut immunity
Expensive painful parentral IM injection
Less antigenicity
Need Booster
l2en
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