virology Flashcards
How is HIV transmitted?
1) Mainly blood-borne, unprotected intercourse are the main routes.
2) Contact between damaged skin / mucosa with body secretions also poses a risk,
albeit lower than (1).
Which immune cell type is attacked by HIV?
dendritic cells: transport virus to CD4 T cells in lymph nodes
What happens to the patient as the immune system succumbs to HIV?
incubation period 2-4 weeks, may be as long as 10 weeks, leading to:
Primary HIV infection / seroconversion syndrome
~Years later (range from 1-2 to > 10 years later)~
–>As CD4 count drops, patient presents with AIDS-defining infection(s), especially when
CD4 count drops < 200/µm3
–>
AIDS (Acquired immunodeficiency syndrome)
How do you test for HIV?
First line test : Antibody + p24 antigen combined screening test
Is there treatment/ vaccine for HIV?
- lifelong HAART (highly active antiretroviral therapy)
- increase CD4 above 200
- suppress HIV viral load to undetectable level
- monitor CD4 count (blood test)
- monitor HIV viral load (blood PCR)
- genotyping of HIV may be indicated to detect viral mutation which could help predict / confirm drug resistance
- antibiotic prophylaxis against opportunistic infections
What is the life expectancy of a HIV patient if he/she is on treatment?
prognosis q good
Answer questions below about: Measles ; acute respi illness
1. How does the infection present clinically?
Symptoms :
-
-
-
- Coryza (aka Rhinitis, irritation & inflammation of mucous membrane inside nose)
- Conjunctivitis
- Pathognomonic enanthema (Koplik spots = tiny white spots): May appear __ to __ days after symptoms inside the mouth
- __ to __ days after: measles rash
- maculopapular rash, usually appears about __ days after a person is exposed: rash spreads from head to trunk of lower extremities
- How is it spread – touch/saliva / airborne etc.
Patients are contagious from __ days before to __ days after the rash appears.
sometimes immunocompromised pt do not develop the rash One of the most contagious disease - __ out of __ with close contact to measles pt will develop measles
Virus transmitted by :
direct contact with infectious droplets
Airborne : when infected person breathes, coughs, sneezes
Measles can remain infectious in the air for up to 2hrs - Is it serious – why? What can happen to the patient?
Otitis media
Bronchopneumonia
Laryngotracheobronchitis
Diarrhoea
→ __ out of every 1000 will develop acute encephalitis, often results in permanent brain damage
→ __ to __ of every 1000 children who become infected with measles will die from respiratory and neurologic complications
Subacute sclerosing panencephalitis is a rare, fatal degenerative disease of the CNS characterized by:
Behavioral and Intellectual deterioration
Seizures
These generally develop __ to __ years after measles infection.
Risk for complications :
Infants and children < 5 years
Adults > 20 years
Pregnant woman
People with compromised immune systems (eg HIV, leukemia)
- Consequence on foetus/baby if infected during pregnancy
Measles may cause pregnant women who have not had the MMR vaccine to give birth __, or have a __ __ __baby. - Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Symptoms :
- Fever (40.5°C)
- Malaise
- Cough
- Coryza (aka Rhinitis, irritation & inflammation of mucous membrane inside nose)
- Conjunctivitis
- Pathognomonic enanthema (Koplik spots = tiny white spots): May appear 2-3 days after symptoms inside the mouth
- 3-5 days after : measles rash
- maculopapular rash, usually appears about 14 days after a person is exposed: rash spreads from head to trunk of lower extremities - Patients are contagious from 4 days before to 4 days after the rash appears.
sometimes immunocompromised pt do not develop the rash
One of the most contagious disease - 9 out of 10 with close contact to measles pt will develop measles
Virus transmitted by :
direct contact with infectious droplets
Airborne : when infected person breathes, coughs, sneezes
Measles can remain infectious in the air for up to 2hrs
- Common complications :
Otitis media
Bronchopneumonia
Laryngotracheobronchitis
Diarrhoea
→ One out of every 1000 will develop acute encephalitis, often results in permanent brain damage
→ One to three of every 1000 children who become infected with measles will die from respiratory and neurologic complications
Subacute sclerosing panencephalitis is a rare, fatal degenerative disease of the CNS characterized by :
Behavioral and Intellectual deterioration
Seizures
These generally develop 7 to 10 years after measles infection.
Risk for complications :
Infants and children < 5 years
Adults > 20 years
Pregnant woman
People with compromised immune systems (eg HIV, leukemia)
- Measles may cause pregnant women who have not had the MMR vaccine to give birth prematurely, or have a low birth weight baby.
- No specific antiviral therapy
- YES: MEASLES MUMPS RUBELLA (MMR) VACCINE
Answer questions below about: Mumps
1. How does the infection present clinically?
Mumps : a __ __ caused by paramyxovirus, a member of the Rubulavirus family
- Avg incubation period is __ to __ days
- usually involves pain, tenderness and swelling in one or both __ __ glands
→ swelling usually peaks in __ to __ days then subsides during the next week
→ swelling tissue pushes the angle of the ear up and out. As it worsens, the angle of the jawbone below the ear is no longer visible
Symptoms :
- Low grade fever lasting __ to __ days
- Myalgia
- Anorexia
- Malaise
- Headache
- Parotitis usually lasts __ days
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Mumps : a viral illness caused by paramyxovirus, a member of the Rubulavirus family
- Avg incubation period is 16-18 days
- usually involves pain, tenderness and swelling in one or both parotid salivary glands
→ swelling usually peaks in 1-3 days then subsides during the next week
→ swelling tissue pushes the angle of the ear up and out. As it worsens, the angle of the jawbone below the ear is no longer visible
Symptoms :
- Low grade fever lasting 3-4 days
- Myalgia
- Anorexia
- Malaise
- Headache
- Parotitis usually lasts 5 days
- Transmitted person to person through direct contact with saliva, respiratory droplets
Infectious period is 2 days before to 5 days after parotitis onset
Infected person should avoid contact with from others
- Complications : mostly itis
Orchitis
Oophoritis
Mastitis
Meningitis
Encephalitis
Pancreatitis
Hearing loss
→ Complications can occur in the absence of parotitis and occur less frequently in vaccinated patients
→ Some complications are known to occur more frequently among adults than children
- Mumps that occur in pregnant woman is generally benign and not more severe than in women who are not pregnant.
Case study found relation in babies being born with congenital malformations to mothers who had mumps during pregnancy
- No specific treatment for mumps, only to help manage symptoms
- YES : MEASLES MUMPS RUBELLA (MMR) VACCINE
Answer questions below about: Rubella
1. How does the infection present clinically?
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy – this applies especially to CMV, VZV, Measles, Rubella, Hepatitis B and C, HIV, HSV, CMV
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Rubella is a viral illness.
Children :
Rubella is usually mild with few noticeable symptoms.
Red rash usually the first sign, lasts about 3 days
Symptoms that may occur 1-5 days before rash appears :
Low grade fever
Headache
Conjunctivitis
Swollen and enlarged lymph nodes
Cough
Runny nose
Adults :
Mild, maculopapular rash along with lymphadenopathy
Rash starts on the face and spreads to the body
Slight fever
Sore throat
Conjunctivitis
Headache - Transmitted primarily through direct or droplet contact from nasopharyngeal secretions
Humans are the only natural hosts
Infections usually occur during late winter, early spring
→ people with rubella are most contagious when the rash is erupting, can be contagious from 7 days before to 7 days after the rash appears
Arthralgia or arthritis may occur in up to 70% of adult woman with rubella. - Rare complications :
Thrombocytopenic purpura
Encephalitis
Rubella is very dangerous for pregnant women and developing baby. - Rubella infections during pregnancy, especially during FIRST trimester can result in :
Miscarriage
Fetal death / stillbirths
Severe birth defects known as Congenital Rubella Syndrome (CRS)
Most common congenital defects are cataracts, heart defects, hearing impairment - No specific antiviral therapy
- YES : MEASLES MUMPS RUBELLA (MMR) VACCINE
Answer questions below about: Common Cold/ rhinovirus
1. How does the infection present clinically?
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Many people will have no symptoms. Among those who develop symptoms, they typically last about 7 days but can last up to two weeks. Symptoms may include:
Cough
Sneeze
Runny Nose
Nasal congestion
Sore throat
Headache
Body Aches
Fever
- Rhinoviruses are spread through respiratory droplets that are released when an infected person coughs or sneezes. These droplets can enter another person’s body if they breathe them in, or if they touch a surface contaminated with the virus and then touch their eyes, nose, or mouth. Rhinoviruses can also be spread through close personal contact with an infected person, such as shaking hands or hugging.
- No, but More severe illness is less common but can include asthma exacerbations, bronchioliti middle ear infections, sinusitis, bronchitis, or pneumonia. These symptoms can mirror other respiratory infections.
- no
- no
Answer questions below about: COVID
1. How does the infection present clinically?
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy – this applies especially to CMV, VZV, Measles, Rubella, Hepatitis B and C, HIV, HSV, CMV
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Myalgia (Muscle or body aches)
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea - COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. In some circumstances, they may contaminate surfaces they touch.
- Not always. Can be mild/moderate, severe/critical.
In severe/critical:
Look for emergency warning signs for COVID 19:
Trouble breathing
Persistent pain or pressure in the chest
New confusion
Inability to wake or stay awake
Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
- completion of a 2-dose mRNA COVID-19 vaccination series during pregnancy was associated with a reduced risk of hospitalization for COVID-19, including for critical illness, among infants younger than 6 months of age
- Yes
- Yes, iykyk
Answer questions below about: VZV (varicella or chicken pox)
1. How does the infection present clinically?
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Rash that appears first on chest, back and face then spread over the entire body
In unvaccinated person: (symptoms last 4-7 days)
Rash (generalized & pruritic)
Progresses rapidly from macular to papular to vesicular lesion before crusting
In healthy children (unvaccinated)(symptoms last 2-3 days)
Itchy rash
Malaise
Temp up to 38.9
In vaccinated person (breakthrough varicella)
Afebrile or have low fever
Develop fewer than 50 skin lesions
Rash is more likely to be predominantly maculopapuar rather than vesicular
The virus can be spread from person to person by direct contact, inhalation of aerosols from vesicular fluid of skin lesions of acute varicella or zoster, and possibly through infected respiratory secretions that also may be aerosolized.
- Based on studies of transmission among household members, about 90% of susceptible close contacts will get varicella after exposure to a person with disease.
Common complication
In children: Bacterial infections of the skin and soft tissues
In adults: Pneumonia - Severe complcation are due to bacterial infection such as
Septicemia
Toxic shock syndrome
Necrotizing fasciitis
Osteomyelitis
Bacterial pneumonia
Septic arthritis
Immunocompromised people : risk of developing visceral dissemination (VZV infection of internal organs) leading to pneumonia, hepatitis, encephalitis, and disseminated intravascular coagulopathy. They can have an atypical varicella rash with more lesions, and they can be sick longer than immunocompetent people who get varicella. New lesions may continue to develop for more than 7 days, may appear on the palms and soles, and may be hemorrhagic.
- If a pregnant woman gets varicella in her first or early second trimester, her baby has a small risk (0.4 to 2.0%) of being born with congenital varicella syndrome. The baby may have scarring on the skin; abnormalities in limbs, brain, and eyes, and low birth weight.
If a woman develops varicella rash from 5 days before to 2 days after delivery, the newborn will be at risk for neonatal varicella
- YES
- YES : varicella vaccine
Answer questions below about: Influenza
1. How does the infection present clinically?
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy – this applies especially to CMV, VZV, Measles, Rubella, Hepatitis B and C, HIV, HSV, CMV
- Vaccine available? (Yes/No)
- Fever*/feeling feverish or chills
Cough
Sore throat
Runny or stuffy nose
Muscle or body aches
Headaches
Fatigue (tiredness)
Some people may have vomiting and diarrhea, though this is more common in children than adults.
*It’s important to note that not everyone with flu will have a fever. - Person to Person.
People with flu can spread it to others. Most experts think that flu viruses spread mainly by droplets made when people with flu cough, sneeze, or talk. These droplets can land in the mouths or noses of people who are nearby (usually within about 6 feet away) or possibly be inhaled into the lungs. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes. - elderly, children, pregnant, immunocompromised
- A common flu symptom is fever, which has been associated in some studies with neural tube defects and other adverse outcomes for a developing baby
- Yes
Answer questions below about: RSV
1. How does the infection present clinically?
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy – this applies especially to CMV, VZV, Measles, Rubella, Hepatitis B and C, HIV, HSV, CMV
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Runny nose
Decrease in appetite
Coughing
Sneezing
Fever
Wheezing - An infected person coughs or sneezes
You get virus droplets from a cough or sneeze in your eyes, nose, or mouth
You have direct contact with the virus, like kissing the face of a child with RSV
You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands - Can be serious in Infants, young children and older adults
- Idk man they only said abt vaccine for pregnant woman
- No, only treat symptoms
- Yes, New RSV vaccines are available for adults 60 and older. two safe and effective immunizations for infants. ew RSV vaccine is recommended for pregnant people who are 32–36 weeks pregnant with seasonal administration during September–January
Answer questions below about: cytomegalovirus (CMV)
1. How does the infection present clinically?
Mostly____
- How is it spread – touch/saliva / airborne etc.
- Is it serious – why? What can happen to the patient?
- Consequence on foetus/baby if infected during pregnancy – this applies especially to CMV, VZV, Measles, Rubella, Hepatitis B and C, HIV, HSV, CMV
- Any treatment – yes or no only
- Vaccine available? (Yes/No)
- Most are asymptomatic.
In some cases, infection in healthy people can cause mild illness that may include:
Fever
Sore throat
Fatigue
Swollen glands
Occasionally, CMV can cause mononucleosis or hepatitis (liver problem). - Direct contact with infectious body fluids, such as urine, saliva, blood, tears, semen, and breast milk. CMV can be transmitted sexually and through transplanted organs and blood transfusions. CMV can be transmitted to infants through contact with the mother’s genital secretions during delivery or through breast milk.
- People with weakened immune systems who get CMV can have more serious symptoms affecting the eyes, lungs, liver, esophagus, stomach, and intestines.
Babies born with CMV can have brain, liver, spleen, lung, and growth problems. The most common long-term health problem in babies born with congenital CMV infection is hearing loss, which may be detected soon after birth or may develop later in childhood.
- The risk of complications to the fetus is greatest if a primary infection occurs during the first trimester.
Most infants with congenital CMV infection never have health problems. About 10% of infants with congenital CMV infection will have health problems at birth, which include:
Rash
Jaundice (yellowing of the skin or whites of the eyes)
Microcephaly (small head)
Low birth weight
Intrauterine growth restriction (low weight)
Hepatosplenomegaly (enlarged liver and spleen)
Seizures
Retinitis (damaged eye retina)
About 40 to 60% of infants born with signs of congenital CMV disease at birth will have long-term health problems, such as:
Hearing loss
Vision loss
Intellectual disability
Microcephaly (small head)
Lack of coordination or weakness
Seizures
- No.
(No treatment is currently indicated for CMV infection in healthy people. Antiviral treatment is used for people with compromised immune systems who have either sight-related or life-threatening illnesses due to CMV infection.) - No, still in research & development stage
