Viral respiratory tract infections Flashcards by Orla Mcdonnell

What is the contact transmission route?

Direct: deposited on persons, viruses transfer from one person to another
Indirect: deposited on objects: virus transfer through contaminated intermediate objects (fomites)

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What viruses can cause pharyngitis?

Rhinovirus
Human coronaviruses
Adenoviruses
Parainfluenza viruses
Human metapneumovirus
Influenza viruses

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What virus can cause croup?

Parainflenza

* Influenza

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What viruses can cause bronchiolitis?

RSV

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What viruses can cause pneumonia?

Influenza
SARS
SARS CoV-2

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What are the complications of the common cold?

otitis media
Sinusitits
Severe infection in the vulnerable groups

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What are the symptoms of the common cold?

Nasal congestion/obstruction
Sore/scratchy throat
Sneezing
Cough
Headache
Fever
Hoarseness
Fatigue

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What are the two most common causes of the common cold?

Rhinovirus

* Seasonal coronaviruses

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What are the symptoms of pharyngitis?

•Sore throat
•Fever
•Pharyngeal inflammation
(• Coryza, hoarseness, cough)

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What appearances are indicative of a bacterial infection in the oropharynx?

Palatal petechiae

* Exudative tonsil hypertrophy

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What appearances are indicative of a viral infection of the oropharynx?

Pahryngeal redness

* Tonsillar erythema

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What appearance is indicative of a fungal infection in the oropharynx?

Angular chelitis

* Curdlike plaques

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What is the peak age of croup?

2 years

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What are the early signs of croup?

Fever
Rhinorrhoea
Cough
Sore throat

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What are the symptoms of croup (not prodromal)?

Nonproductive harsh seal like cough
Inspiratory stridor
Tachypnoea
Subglottic obstruction

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What are the complications of croup?

Intubation

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What is the main cause of croup?

Parainfluenza viruses 1-4

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What is the incubation period of bronchiolitis?

3 to 5 days

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What is bronchiolitis?

Inflammation and narrowing of the small airways
Attaches to the airway epithelial cells which are then shed
Mucous production and oedema due to inflammation

What are the symptoms of RSV in young children?

•Low grade fever
•Wheezing 
•Increasing respiratory effort
 - chest wall retraction 
 - tachypnoea
 - nasal flare 
•Reduced oral intake 
•Apnoea in <6 weeks of age

What is there an association of with RSV in young children?

The development of asthma

What can be given to high risk infants to help with RSV?

Prophylactic monoclonal antibody (Palivizumab/synagis)

* IM given monthly during RSV period/season

how long can RSV survive on surfaces?

4-7 hours

What are the control measures if a patient in hospital has RSV?

Cohort, PPE, hand washing

What are the symptoms of RSV in older children and adults?

* Mild to moderate symptoms * Viral induced wheeze * Viral pneumonia * Exacerbation of COPD and asthma

Which groups are more at risk of severe complications of RSV infection?

* Elderly * Chronic underlying lung/cardiac disease * Immunocompromised

What is the treatment of RSV?

* Supportive: oxygen supplementation and fluids | * Ribavirin

What is the natural reservoir for influenza A?

Wild birds

What is the natural reservoir for influenza B?

Humans

Describe antigenic drift in influenza

Mutations can alter the amino acid structure of the protein haemaglutinin which is a main target by the adaptive immune system, affecting antibody affinity

What is antigenic shift

If someone is infected with two different forms of the virus at the same time, there can be a reassortment resulting in a new virus

What are the neurological symptoms of influenza?

* Headache * Fever * Confusion

What are the neurological complications of influenza?

* Febrile convulsions * Reyes syndrome * Meningitis/encephalitis * Transverse myelitis * Guillain barre syndrome

What are the respiratory symptoms of influenza?

* Dry cough * Sore throat * Nasal congestion

What are the GI symptoms of influenza?

* Nausea * Vomiting * diarrhoea

What are the musculoskeletal symptoms of influenza?

* Myalgia | * Fatigue

What are the respiratory complications of influenza?

* Otitis media * Croup * Sinusitis/bronchitis/pharyngitis * Pneumonia (viral, or secondary bacterial) * Exacerbation of chronic lung disease

What is the mechanism of action of amantadine?

M2 proton channel blocker in influenza A

Name 2 neuraminidase inhibitors

* Oseltamivir * Zanamivir * Peramivir

Name two polymerase inhibitors

* Baloxavir | * Favipavir

What is the treatment of influenza in the UK?

* Oseltamivir 75mg oral twice daily * Zanamivir 10mg INH twice daily * Both for 5 days

What is the prophylaxis for influenza?

Oseltamivir and zanamivir both once daily for 10 days

Describe the transmission to humans in avian influenza

* Close contact infected bird (respiratory droplets or faeces) * Household contact * Healthcare workers

What are the symptoms of Middle East respiratory syndrome coronavirus?

* Flu like illness (fever, cough) * Dyspnoea * Vomiting * Diarrhoea * Chest pain * Pneumonia

What are the complications of MERS-CoV?

* ARDS * Renal failure * Multi organ failure

What are the benefits of molecular testing?

* Rapid detection * Improves the diagnosis of previously under diagnosed infection * Can be developed to detect new pathogens * Better understanding of respiratory illness, inform public health * New treatments