Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

cdc yellowbook > viral (R-T) > Flashcards

viral (R-T) Flashcards

1
Q

what is rabies virus? family / genus

A

family Rhabdoviridae
genus Lyssavirus
neurotropic = virus travels from bite along peripheral nerves to CNS, where viral replication increases exponentially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

all mammals are susceptible to rabies, but which animals are major rabies virus reservoirs?

A

mesocarnivores and bats;
dogs in low-mid income countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how are rabies virus classifed into 2 major genetic lineages?

A

canine
New World bat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the rate of rabies exposures in travelers?

A

16-200 per 100,000 travelers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when does signs and symptoms develop after rabies exposure?

A

weeks to months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the fist symptom of rabies?

A

pain and paresthesia at the site of exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the symptoms of prodromal phase and neurologic phase of rabies?

A

prodromal - fever, nonspecific, vague symptoms

neurologic - anxiety, paralysis, paresis, encephalitis, muscle spasm (stimulated by sight, sound, perception of water-hydrophobia), delirium, convulsions, coma, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what % of people with rabies manifest with classic encephalitic disease? paralytic rabies?

A

80% - encephalitic
20% - paralytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how to diagnose rabies?

A

definitive antemortem diagnosis - multiple specimens including CSF, saliva, serum, skin biopsies taken from the nape of the neck; sequential sample collection needed if antibody detection varies over the course of illness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

after the first symptom occurs, how soon does the rabies progress to coma/death?

A

7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how to treat rabies?

A

early and robust production of rabies virus-neutralizing antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

besides rabies virus, what are other bat-associated pathogens?

A

histoplasma spp., coronaviruses, viral hemorrhgic fever viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why pre-exposure prophylaxis is recommended for rabies?

A
  • it simplifies PEP
  • some protection when an exposure to rabies virus goes unrecognized, or PEP is otherwise delayed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are 5 risk categories of rabis for people?

A
  1. elevated risk for unrecognized & recognized exposures, including unusual or high-risk exposures
  2. elevated risk for unrecognized and recognized exposures
  3. elevated risk for recognized exposures or sustained risk
  4. elevated risk for recognized exposure, no sustained risk
  5. low risk for exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

for category 1 population for risk of rabies, who are typical population?
what is the dose for prEP?

A

people working with live virus in research or vaccine production facilities
people performing testing for rabies in diagnostic lab

0, 7 days; then check every 6 months (booster if <0.5IU/mL8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

for category 2 population for risk of rabies, who are typical population?
what is the dose for prEP?

A

people with frequent bat contact, who perform animal necropsies

0, 7 days; then check every 2 years (booster if <0.5IU/mL8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

for category 3 population for risk of rabies, who are typical population?
what is the dose for prEP?

A

-people who interact with animals that could be rabid
-occupational or recreational activities typically involve contact with animals,
-selected travelers

-0, 7 days; then one time tier check during years 1-3 after OR
-0, 7 days; then booster dose at 21 days - 3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

for category 4 population for risk of rabies, who are typical population?
what is the dose for prEP?

A
  • same at risk populations as category 3, but risk less then 3 years

-0, 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

which travelers should be considered for PrEP for rabies?

A
  1. any occupational or recreational activities that increase their risk for exposure to potentially rabid animals (particularly dogs)?
  2. no access to safe postexposure prophylaxis? (rural areas, no PEP readily available)
  3. duration of stay / repeat travel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are 2 types of rabies vaccines available?

A

Human Diploid Cell Rabies Vaccine (HDCV) - Imovax
Purified Chick Embryo Cell vaccine (PCEC) - RabAvert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

compare to PCEC, HDCV has higher chance of getting this adverse reaction..

A

systemic hypersensitivity reacions - malaise, pruritis, urticaria - 6% of ppl receiving booster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how to do first aid if animal bite?

A

copious amounts of soap and water
povidone iodine
or other products with virucidal activity

-clean immediately!
-delay suturing any wounds for a few days if unvaccinated
-inject rabies immune globulin into all exposed tissues before closing the wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

if vaccinated, what is post exposure prophylaxis of rabies?

A

2 doses of modern cell culture vaccine ASAP - 0, 3 days
rabies immune globulin should not be administered to people who were previously vaccinated - can lead to a dimished immune response to vaccine and provides no benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

if unvaccinated, what is post exposure prophylaxis of rabies?

A

rabies immune globulin
- 20 IU/kg for human RIG (HRIG)
- 40 IU/kg for equine RIG
- inject as much of the dose-appropriate volume of RIG as is anatomically feasible at wound sites

4 or 5 injections of rabies vaccine over 14 days - 0, 3, 7, 14 (and 28 if immunocompromised)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which rabies immunoglobulins are available?

A

human RIG
equine RIG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

if access to RIG is delayed, what to do?

A

start the vacccine ASAP
add RIG 7 days or less after the first dose of vaccine
(after 7 days, no benefit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

can pregnant woman get PEP for rabies?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

rabies vaccines grown in animal brains are still in use in low- and middle- income countries. daily large-volume injection (5ml) 14-21 days. is this safe?

A

no because of variability in the potency - decline and travel to a location where acceptable vaccines and RIG are available.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is rubella virus?

A

spherical, positive-sense, single-stranded RNA
family Matonaviridae
genus Rubivirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how are rubella virus transmitted?

A

-person-to-person
-droplets shed from the respiratory secretions of infected people - shed from 7 days before the onset of the rash to 5-7 days after rash onset
-mother to fetus (highest risk for congenital rubella syndrome if infected in first trimester)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

where is Rubella at risk the most?

A

Africa, East Asia, South Asia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is congenital rubella syndrome?
how common is CRS globally?

A

-born with cataract or congenital heart disease
-mom infected during pregnancy especially before 13th week of pregnancy is at most danger

100,000 cases per year wordlwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are the symptoms of rubella?

A

-25-50% asymptomatic

-rash usually starts on the face, becoming generalized within 24 hours
-anorexia, mild conjunctivitis, low-grade fever, malaise, runny nose, sore throat can occur first before the rash appearance
-adolescents, adults, esp women - can present with transient arthritis.

-rare complications: encephalitis, thrombocytopenic purpura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

how to diagnose rubella?

A

serologic - rubella IgM or significat increase in rubella IgG
-RT-PCR can be used to detect virus infection
-viral culture also ok but time consuming and expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what virus (genus, family) cause measles?

A

genus Morbillivirus
family Paramyxoviridae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

how does measles get transmitted?
what is the contagious period?

A

respiratory droplets
4 days before until 4 days after rash onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the incubation period for measles to onset of prodrome symptoms?
what is prodrome symptoms before rash appears?
when does the rash appear?

A

11-12 days from exposure;
fever, high fever (40.6), conjunctivitis, coryza (runny nose), cough, small spots with white or bluish-white centers on an erythematous base appearing on the buccal mucosa (Koplik spots)

rash appears~14 days (3-7 days after onset of prodromal symptoms)- begin on face and generalized, lasting 4-7 days; red, blotchy (maculopapular) rash

38
Q

what are common measles complications?

A

diarrhea 8%, middle ear infection (7-9%), pneumonia (1-6%)
encephalitis - permanent brain damage - 1 per 1000-2000 cases

39
Q

what is subacute sclerosing panencephalitis (SSPE)?

A

progressive neurologic disorder caused by measles virus that usually presents 5-10 years after recovery from the initial infection.

mental and motor deterioration, can progress to coma and death.

1/5000 cases; higher among children <5 years of age.

40
Q

how to diagnose measles?

A

serologic test - IgM, IgG seroconversion, or a significant rise in measles IgG level

isolation of measles virus
RT-PCR testing

41
Q
A
42
Q

what is the dose of Vitamin A for measles for kids?
<6 months
6 months - 12 months
12 months and older

A

50,000 IU qd for 2 days
100,000 IU qd for 2 days
200,000 IU qd for 2 days

if vit A deficiency, administer an additional (a third) age-specific dose 2-4 weeks

43
Q

when was the measles vaccine licensed?

A

1963

44
Q

acceptable presumptive evidence of immunity to measles includes birth before .. which year?

A

1957

45
Q

what is the routine vaccine schedule for MMR or MMRV?

A

at 12 month, and 28 days later

46
Q

patient was born in 1963-1967 in US - which measles vaccine was administered then, and what should we do for these population?

A

formalin-inactivated measles vaccine - short-lived immunity;
need MMR live vaccine again

47
Q

what is the effectiveness of MMR vaccine in measles after dose 1 at age 9 months? dose 1 at 1 year old?

effectiveness of 2 doses?

A

85%; 93%

97%

48
Q

what are the adverse reactions from MMR vaccine?

A

-anaphylaxis (2-14 / million)
-febrile seizures (1/3000-4000 doses)
-thrombocytopenia (1/40,000 doses)
-joint symptoms (arthralgia ~25% of nonimmune postpubertal females from the rubella component of the MMR vaccination)

49
Q

any egg allergy concern with MMR?

A

no, can receive MMR or MMRV vaccine without prior routine skin testing or the use of special protocols.

50
Q

Is HIV patient ok to get MMR/MMRV?

A

yes - if not immunosupressed:
children 5 and under:
- if CD4 is equal to or greater than 15% for 6 months

children 6 and up:
-CD4 15% and up AND CD4 count 200 cells/ml or more for 6 months

51
Q

after how many months of chemotherapy, can a person get MMR?

A

3 months

52
Q

what is considered high dose steroid?

A

20mg or 2 mg/kg body weight of prednisone, 2 weeks or more

53
Q

how long do you need to wait to get MMR if you had high dose steroid ?

A

1 month

54
Q

how long do you have to wait to get MMR/MMRV after immunosuppressive therapies?

A

3 months

55
Q

how long do you need to wait after getting MMR or other live vaccines to become pregnant?

A

28 days after live-virus vaccine

56
Q

if baby has personal or family history of seizure, which one MMR or MMRV vaccine should be used?

A

MMR and separate varicella vaccine at the same visit

-MMRV has higher chance of fever and febrile seizures 5-12 days after the first dose among children age 12-23 months.
1 febrile seizure / 2,300-2,600 MMRV

57
Q

if the baby has thrombocytopenia after first dose of MMR or MMRV within 6 weeks, do you administer 2nd dose?

A

NO

58
Q

what is post-exposure prophylaxis of measles?

A

-measles-containing vaccine within 72 hours after exposure
-within 6 days, IG

59
Q

after getting measles IG, when can you get vaccination of MMR or MMRV?

A

6 months after IG intramuscularly;
8 months after IG intravenously

60
Q

which virus causes smallpox?

A

variola virus, genus Orthopoxvirus

61
Q

among genus Orthopoxvirus, which viruses can cause human diseases?

A

variola virus (smallpox), cowpox virus, vaccinia virus, mpox virus

62
Q

how are smallpox viruses trasnsmitted?

A

respiratory droplets; contact with infectious skin lesions or scabs

63
Q

how does Vaccinia virus get transmitted?

A

-from live vaccine
-touching the fluid or crust material from the inoculation lesion of someone recently vaccinated against smallpox
-touching contaminated materials like sheets and towels
-contact with agricultural animals, often bovids, infected with sylvatic vaccinia-like viruses

64
Q

how is cowpox virus transmitted?

A

-wild rodents are the reservoirs of cowpox virus
-mammals (cats, cows, humans) are incidental hosts
-direct contact with infected animals including incidental hosts

65
Q

what is suspected reservoir for mpox virus?

A

small mammals - not monkeys

66
Q

how is mpox transmitted?

A

-contact with infected wildlife or wildlife products, infected humans, or the bodily fluids or respiratory droplets from infected wildlife or people
-person-to-person: respiratory secretions and skin contact with lesion or lesions
-contact with infectious materials
-sexual contact; esp. MSM

67
Q

which countries there had been reports of vaccinia-like viruses?

A

Brazil, Columbia - dairy workers;
India - cattle and buffalo herders

68
Q

which countries did Cowpox occur?

A

Europe and the Caucasus (Georgia)

69
Q

which country or regions are at risk of Mpox?

A

West and Central Africa, notably the Congo Basin - Democratic Republic of the Congo;
US - from infected pets from Africa;
Cameroon, Central African Republic, Cote d’Ivoire, Gabon, Liberia, Nigeria, Republic of the Congo, Sierra Leone, Nigeria

70
Q

what are the symptoms of smallpox?

A

acute onset of fever, head and body aches, malaise, sometimes vomiting
-disseminated rash of firm, deep-seated vesicles or pustules in the same stage of development on each affected body site.
-lesions on the palsm or soles and a centrifugal distribution of lesions on the body

71
Q

what are the symptoms of cowpox & Vaccinia?

A

-localized vesicular-pustular lesions
-cowpox occasionally are ulcerative
-most often self-limited

72
Q

what are the symptoms of Mpox?

A

-febrile prodrome
-vesiculopustular rash that sometimes involves the palms and soles
-marked lymphadenopathy - distinguishing from smallpox
-from 2022: different clinical presentation- rash smaller and less diffusely spread
-most self-limited (some death)

73
Q

how to diagnose orthopoxvirus infection?

A

PCR testing or virus isolation

74
Q

how to prevent spreading orthopoxvirus infection to other parts of the body or to other people?

A

keep lesions covered until the scab detaches; avoid touching their eyes before proper hand washing;

75
Q

how to treat ocular involvement from orthopoxvirus infections ?

A

topical antivirals - e.g. trifluridine drops

76
Q

treatment for Mpox?

A

tecovirimat have been used but more evaluations needed;
tecovirimat is available as investigational new drug

77
Q

how to prevent mpox and other orthopoxvirus infection?

A

avoid contact with sick or dead animals, including wild animals, pets, domestic ruminants (buffalo, cattle)

78
Q

who can get vaccines for smallpox?

A

people at occupational risk - lab workers, military personnel

79
Q

who should get vaccinated for mpox?

A

people at risk of mpox exposure and infection during travel complete mpox vaccination series at least 2 weeks prior to departure.

after exposure within 4 days - get vaccination

80
Q

what is the causing agent of TBE (tick-borne encephalitis)?

A

Tick-borne encephalitis virus - single-stranded RNA virus
genus Flavivirus

3 main subtypes: European, Far Eastern, Siberian

81
Q

what are the ticks that cause TBE virus transmission?

A

bite of an infected tick of the Ixodes species,
primarily I. ricinus (European subtype) or I. persulcatus (Far Eastern and Siberian subtypes)

82
Q

what are preferred habitats for ticks causing TBE?

A

in or near the edges of forests with deciduous or coniferous trees and low-growing dense brush

83
Q

what is the primary amplifying host of TBE virus?

A

small rodents

84
Q

what are other ways of getting TBE other than through bite of tick?

A

-ingesting unpasteurized diary products from infected cows, goats, sheep
-direct person-to-person possible but rare

85
Q

which areas are at risk of TBE?
which countries have most reported cases?

A

western and northern Europe through to norther and eastern Asia
-Russia, including Siberia (most reported)
-the Baltic states (Estonia, Latvia, Lithuania), Czech Republic, Slovenia - highest incidence in recent years
-Other European countries with reported cases: Austria, Belarus, Belgium, Bosnia,Bulgaria, Croatia, Denmark, Finland, France, Germany, Hungary, Italy, Liechtenstein, Moldova, Netherlands, Norway, Poland, Romania, Serbia, Slovakia, Sweden, Switzerland, Ukraine, and the United Kingdom.
-Asian countries with reported TBE cases or virus activity include China, Japan, Kazakhstan, Kyrgyzstan, Mongolia, and South Korea.

86
Q

The risk for TBE virus infection for an individual traveler is greatly affected by ….

A

their planned itinerary and activities.

87
Q

the same ticks that transmit TBE virus also can transmit other pathogens, including …?

A

Borrelia burgdorferi (the agent for Lyme disease),
Anaplasma phagocytophilum (anaplasmosis), and
Babesia spp. (babesiosis)

88
Q

what are the symptoms of TBE?

A

-2/3 are asymptomatic
-incubation- 8 days (2-28 days)
-most often milder disease forms or biphasic course:
1. nonspecific febrile illness for several days then asymptomatic period
2. CNS involvement - aseptic miningitis, encephalitis, meningoencephalomyelitis (altered mental status, ataxia, cognitive dysfunction, cranial nerve palsies, limb paresis, meningeal signs, rigidity, seizures, tremors)
-severity increases with age (milder disease in children)

89
Q

how to diagnose TBE?

A

-history of tick bite (30% do not recall a tick bite)
-febrile illness that progress to neuroinvasive disease within 4 weeks
-serology teset: IgM performed on serum or CSF –> when interpreting results, consider the patient’s vaccination history, date of symptom onset, and info about other flaviviruses

-virus isolation and RT-PCR should not be used to rule out TBE

90
Q

what is the vaccine for TBE? dose?
when do you use this vaccine?

A

TICOVAC - inactivated, whole-virus vaccine with formulations for kids 1-15 yr and adults 16 and up.

1-15 years (0.25ml) : 0, 1-3 months, 5-12 months after dose 2
16 and up (0.5ml) : 0, 14 days-3 months, 5-12 months after dose 2
Every 3 years

-vaccine recommended if extensive tick exposure based on planned outdoor activities (camping, fishing, hiking, hunting) and itinerary; moving to endemic area

91
Q

precautions of TICOVAC in pregnancy and lactating?

A

no studies assessed the safety

92
Q
A

cdc yellowbook (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions