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Clinical Micro > Viral RTIs > Flashcards

Viral RTIs Flashcards

1
Q

How are viral RTIs transmitted?

A

Droplet (not aerosol transmission) and then contact (inoculation) with the eyes or nose
- can survive on fomites and non porous surfaces for hours

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2
Q

in what types of places are outbreaks of viral RTIs common?

A

daycares, long term care facilities, in the community in general

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3
Q

based on the study discussed, what is the relative role of hands in the transmission of parainfluenza virus? what about rhinovirus?

A

relatively low for parainfluenza but high for rhinovirus

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4
Q

is it easy or difficult to transmit rhinovirus by kissing?

A

difficult actually

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5
Q

Cold viruses can linger on hotel room surfaces for how long after contamination…

A

18 hours

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6
Q

In the rhinovirus/hotel room study, what were common locations to be contaminated?

A

door handles, light switches, faucets, telephones and TV remote controls

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7
Q

What two viral and two host characteristics controbute to the severity of a RTI?

A

virus: inoculum size and virulence traits
host: immune system and any comorbidities

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8
Q

What is the most common viral cause of an RTI? which one is #2

A
  1. rhinovirus

2. coronavirus

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9
Q

What are a couple other common viral causes of RTIs? which two cause severe disease?

A

Coronavirus, parainfluenza virus, adenovirus

Respiratory syncytial virus (RSV) and Influenza virus (FluA and FluB) cause severe illness

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10
Q

What type of viruses can cause RTIs in immunocompromised individuals?

A

Herpes virus family (HSV, VZV, CMV, EBV)

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11
Q

What predisposes immunocompromised patients to developing antiviral resistance?

A

prolonged periods of virus shedding

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12
Q

What is the best form of specimen collection for upper respiratory tract infections ?

A

Nasopharyngeal swabs or aspirates

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13
Q

What is the best form of specimen collection for lower respiratory tract infections?

A

Bronchial alveolar lavages (BAL)

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14
Q

What kind of swab is the best to use? what kind of media is required?

A

a flocked swab is best

transport media (doesn’t support growth) is required

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15
Q

What is the best laboratory diagnostic technique for detecting respiratory viruses?

A

Molecular methods like quantitative RT-PCR

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16
Q

What trio of diseases can quantitative RT-PCR be used to quickly diagnose? How long does it take?

A

FluA/B/RSV

about 45 min

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17
Q

What is conventional multiplex RT-PCR used for? how long does it take?

A

used if the typical RT-PCR does not detect Flu A/B or RSV then it can be used to screen for 15 different RTI causing viruses simultaneously

About 6 hours

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18
Q

what family of viruses does rhinovirus belong to? what type of genome does it have? what morphology?

A

Picornaviridae family

ssRNA(+), non-enveloped

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19
Q

How many different serotypes of rhinovirus are there?

A

> 100 serotypes

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20
Q

what family of viruses does coronavirus belong to? what type of genome does it have? what morphology?

A

Coronaviridae family

ssRNA(+), enveloped

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21
Q

What are two coronaviruses that have caused more severe illness?

A

SARS and MERS-CoV

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22
Q

what family of viruses does enterovirus belong to? what type of genome does it have? what morphology?

A

Picornaviridae family

ssRNA(+), non-enveloped

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23
Q

How many species and how many serotypes of enterovirus are there?

A

12 species

> 100 serotypes

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24
Q

Enterovirus typically causes mild respiratory illness but has been linked with more sever cases of…

A

aseptic meningitis*, myocarditis, acute flaccid paralysis (polio type illnesses with paralysis)

25
Q

what family of viruses does Respiratory Syncytial Virus (RSV) belong to? what type of genome does it have? what morphology?

A

Paramyxoviridae family

ssRNA-, enveloped

26
Q

RSV is the most common cause of…

A

bronchitis in children

27
Q

Do people have longterm immunity to RSV?

A

no, this is why adults can get it from children relatively easily

28
Q

What is the name of the preformed monoclonal antibody used to treat RSV? what type of antibody and what type of immunization is this?

A

Palivizumab

IgG

Passive immunization

29
Q

what family of viruses does Parainfluenza virus belong to? what type of genome does it have? what morphology? How many types are there?

A

Paramyxoviridae family

ssRNA(-), enveloped

4 types (1 to 4)

30
Q

What is an example of a DNA virus we discussed?

A

Adenovirus

31
Q

Is adenovirus enveloped or non-enveloped

A

Enveloped

32
Q

How many types of adenovirus have been identified?

A

over 60

33
Q

What are 4 symptomatic presentations of an adenovirus infection?

A

URTIs or LRTIs
Conjunctivitis
Hemorrhagic cystitis
Diarrhea

34
Q

What two types of adenovirus cause diarrhea?

A

40 and 41

35
Q

what family of viruses does Influenza virus belong to? what type of genome does it have? what morphology? How many types are there?

A

Orthomyxoviridae

ssRNA- , enveloped

**Segmented genome

36
Q

How many types of Flu are there?

A

3 - A, B, and C (C is very rare)

37
Q

Which of the types of flu has pandemic potential? Which causes more severe disease?

A

Flu A does both

38
Q

What two surface structures are used to subtype the different flus?

A

Hemagglutinin (HA)

Neuraminidase (NA)

39
Q

What symptoms are common for the flu but rare for other respiratory infections?

A

Flu: headache, fever, malaise, fatigue, weakness, muscle aches

Others: nasal congestion and discharge

40
Q

What are the two classes of antiviral treatments of influenza? what is an example of each?

A
  1. M2 inhibitors - Amantidine

2. Neuraminidase inhibitors -oseltamivir and zanamivir

41
Q

How does amantidine work?

A

prevents the formation of M2 proteins which are required to make proton channels for the virus to uncoat

42
Q

Why isn’t amantidine used anymore?

A
  1. All Flu B strains are resistant naturally because they don’t have M proteins
  2. All H3N2 Flu A human strains are resistant naturally
  3. Pandemic H1N1 is resistant
43
Q

What is the issue with the neuraminidase inhibitors?

A

need to be used within 48 hours of infection which is very difficult to manage clinically

44
Q

What are the trivalent/quadrivalent flu vaccines effective against?

A

Influenza A (pH1N1)
Influenza A (H3N2)
Influenza B
- Victoria and Yamagata lineages

45
Q

Why does the flu vaccine need to be updated every year ?

A

because of antigenic drift

46
Q

What is antigenic drift? in what strains does it occur?

A

can occur in both Flu A and Flu B

Due to mutation over time in surface glycoproteins

47
Q

What is the role of hemaggluttinin (HA) ? what does it bind?

A

Hemagglutinin (HA) binds sialic acid receptors on cells to facilitate entry

48
Q

What is the role of neuraminidase (NA)?

A

Neuraminidase (NA) cleaves HA/sialic acid = vial release

49
Q

What is antigenic shift? in what strains does it occur ?

A

Genetic reassortments between avian/swine/human

Only in Flu A

50
Q

What is the result of antigenic shift?

A

pandemics due to no existing immunity to the viral antigens

51
Q

What is the natural reservoir of influenza?

A

Aquatic birds

52
Q

which animal acts as the “mixing ground” for flu viruses? why?

A

pigs because they have both avian and human Flu receptors

53
Q

how many different HA and NA types are there naturally in birds?

A

18 HA and 9 NA in birds naturally

54
Q

which strain of pandemic flu was a triple reassortment?

A

H1N1

- avian, human, and swine

55
Q

What strain of flu is avian flu?

A

H5N1

56
Q

How is avian flu transmitted ? When are people most likely to be exposed?

A

direct contact with infected poultry, or objects contaminated by their feces

Exposure is most likely during poultry slaughter and cooking preparation

57
Q

Can avian flu be transmitted from human to human?

A

NO

58
Q

What is the difference in disease severity and spread between H1N1 and H5N1?

A

H1N1 spreads quickly but rarely fatal

H5N1 spreads very minimally but tends to be fatal

59
Q

What is H7N9?

A

An avian flu that was first reported in humans in March 2013, in China – linked to 144 cases; 46 deaths

H7N9 vaccine developed in Oct 2013

Clinical Micro (28 decks)

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