Virology

Question 1

Mpox - definition

Answer 1

Zoonotic orthopox virus with main animal reservoir being rodents

Clade II - West African - IIb the cause of outbreak MSM in 2022

Clade I - Central African

Question 2

Mpox - transmission

Answer 2

Person to person through direct contact, respiratory secretions, low risk through touching clothing, mother to child during pregnancy

Question 3

Mpox clinical symptoms

Answer 3

Day 1 - 5 Prodrome with fever, headache, fever
Macules to papulses to vesicles to pustules to scabs
Proctitis, pharyngitis, abscesses, pneumonia, encephalitis in severe cases (HIV CD4 <50)

Question 4

Yellow fever - definition

Answer 4

Flavirvirus transmitted by aedes agypti mosquito endemic in South America and Africa. Howler monkey included in the life cycle (human is a dead end host)

Question 5

Yellow fever clinical features

Answer 5

Asymptomatic
Fever, chills, headache, myalgia
Liver failure, encephalitis and DIC in severe cases

Question 6

Yellow fever vaccination contraindications and considerations

Answer 6

Live attenuated vaccine and needs embryonated egg and cold chain

Avoid in immunocompromised
Elderly at greater risk of complications like viscerotropic disease and neurotropic disease
Hypersensitivity reactions (egg allergy as well)
Infants
1st degree relative with viscerotropic or neurotropic complications
Avoid in thymus disorder (MG, thymectomy)

Question 7

Chikungunya definition and clinical syndrome

Answer 7

Alphavirus
Similar presentation to dengue
Vaccine available
Has been known to cause perinatal infections and encephalitis in neonates

Question 8

Oropuche virus definition and clinical syndrome

Answer 8

Transmitted by midges
Often asymptomatic, with some reports of vertical transmission

Question 9

Zika - definition

Answer 9

Flavivirus transmitted by aedes agypti/albopictus as well as sexual transmission and mother to child. No vaccination

Question 10

Zika virus - clinical presentation

Answer 10

Incubation 3-12 days
Rash, fever, joint pain, conjunctivitis, headache, myalgia
Asymptomatic (80%)

Question 11

Zika virus complications

Answer 11

1. Congenital including microcephaly, developmental delay, epilepsy and eye complications (macular scarring, cataracts, glaucoma)
2. Neurological GBS

Question 12

Zika virus diagnostics

Answer 12

1. PCR
   - Blood and urine (urine lasts longer)
   - Helpful in early infection or in detecting it in placental/umbilical cord blood
2. Serology
   - Lots of cross-reactivity with other arboviruses
   - Can be helpful to watch IgM seroconvert to IgG

Question 13

HTLV1 definition

Answer 13

RNA retrovirus spread by cell to cell contact

Question 14

HTLV1 geographical distribution

Answer 14

Japan, Latin America, Caribbean, Africa, Central Australia

Question 15

HLTV1 transmission

Answer 15

Vertical, horizontal, blood contacts

Question 16

HTLV1 - clinical presentation

Answer 16

95% asymptomatic
HTLV1 associated myelopathy (HAM) or tropical spastic paraparesis
Adult T cell lymphoma/leukaemia

Question 17

Systemic complications of HTLV1

Answer 17

Infective dermatitis, strongyloides, autoimmune

Question 18

HTLV1 - diagnostics

Answer 18

Serology EIA/Western blots, Provial PCR