Viruses Flashcards
1
Q
Adenovirus Basics
A
Where: upper + lower respiratory tract
What type: naked DNA
Geography/season: worldwide, no seasonality
Risk: younger than 14, crowded areas
Transmission: contact with respiratory secretions, contaminated swimming pools, fingers to eyes, infects mucoepithelial cells in respir. and GI tract
2
Q
Adenovirus Infection
A
Infants/young: respiratory disease
Children: pharyngoconjunctival fever (flu + pink eye)
Infants, young, military, immunocomp.: pneumonia
GI virus: types 40 and 41
3
Q
Adenovirus Laboratory
A
Molecular detection*
Antibody/antigen
Cell culture
Antiviral: none
Vaccine: serotypes 4,7
4
Q
Human Bocavirus Basics
A
Where: upper and lower respiratory
What type: naked DNA
Geography/season: worldwide, late winter/spring
Risk: children
Transmission: contact with respiratory secretions
5
Q
Human Bocavirus Infection
A
Self limiting
Wheezing/bronchiolitis in young children
Gastroenteritis in children (~30%)
Most prevalent in children 6 months - 3 years
6
Q
Human Bocavirus Laboratory
A
Molecular, ab/ag
Antiviral: none
Vaccine: none
7
Q
Coronavirus Basics
A
Where: upper + lower respiratory tract
What type: enveloped RNA
Geography/season: worldwide, fall/winter but can be whenever
Risk: unvaccinated, younger/infants, cardiopulmonary disease, elderly, immunocomp.
Transmission: contact with respiratory secretions, direct exposure to droplets on mucous membranes, touching membranes with hands
8
Q
Coronavirus Infection
A
Common cold (2nd most common cause)
15% of upper respir. tract infections
SARS (atypical pneumonia)
Gastroenteritis
9
Q
Coronavirus Laboratory
A
Molecular, antigen POCT
Antivirals: yes
Vaccine: yes
10
Q
Enterovirus Basics
A
What type: naked RNA
Geography/season: worldwide, summer/autumn
Risk: everyone, <18 yo more likely to show symptoms
Transmission: fecal-oral, contact with secretions (fomites possible)
Asymptomatic shedding up to 1 month
11
Q
Enterovirus Infection
and laboratory
A
Fever, runny nose, sneeze, cough
Asthmatic children: wheezing, breathing problem
Acute flaccid myelitis: sudden onset limb weakness (outbreaks)
Antivirals: yes
Vaccine: no
Molecular
12
Q
Hantavirus Basics
A
What type: enveloped RNA
Geography/season: common in summer
Risk: everyone
Transmission: rodent contact, inhaling aerosolized excretions
Sin Nombre and Seoul virus
13
Q
Hantavirus Infection
A
HANTAVIRUS PULMONARY SYNDROME (HPS)
- caused by Sin Nombre virus
1-8 weeks post exposure, a lot in western US
Fatigue, fever, muscle ache, cough, shortness of breath, respiratory failure, death within days (38% fatality)
HEMORRHAGIC FEVER WITH RENAL SYNDROME
- caused by Seoul virus
Many mild cases, headache, back and abd. pain, fever, nausea, blurred vision, rash
Low blood pressure, vascular leakage, acute kidney failure (1-15% fatality)
14
Q
Hantavirus Laboratory
A
Antibody, molecular
Antiviral: no
Vaccine: no
15
Q
Influenza Basics
A
Where: upper and lower resp. tract
What type: enveloped RNA, type A and B
Geography/season: worldwide, winter
Risk: unvaccinated, elderly, immunocomp., cardiac or respiratory problems
Transmission: contact with secretions, school children, infectious aerosols
16
Q
Influenza Antigenic Changes
A
Shifts: major change in surface antigens
Genetic recombination, can cause pandemic
Drifts: minor change in surface antigens
Point mutations in gene segment
17
Q
Influenza Infection
A
Acute influenza (adults): rapid fever, malaise, myalgia, sore through, cough
Acute (children): like adults, higher fever, GI tract symptoms, vomiting, otitis media, myositis, croup
Complications: primary pneumonia, secondary bacterial pneumonia, cardiac problems, encephalitis, neurological issues
18
Q
Influenza Laboratory
A
Antigen POCT, molecular, cell culture, EIA
Antiviral: yes
Vaccine: yes
19
Q
Human Parainfluenza Basics
A
Where: upper + lower resp. tract
What type: enveloped RNA
Respirovirus 1 and 3
Rubulavirus 2 and 4
Geography/season: worldwide
Respirovirus 1 - autumn every other year
3 - spring, summer
Rubulavirus 2 - autumn every other year
4 - autumn, winter
Risk: all, more severe for infants
Transmission: contact with respir. secretions
20
Q
Human Parainfluenza Infection
A
Cold like symptoms
Croup (barking cough) - respirovirus 1, rubulavirus 2
Bronchiolitis, bronchitis + pneumonia - respirovirus 3
21
Q
Human Parainfluenza Laboratory
A
Molecular, culture
Antivirals: no
Vaccine: no
22
Q
Human Metapneumovirus Basics
A
Where: lower respir. tract
What type: enveloped RNA
Geography/season: worldwide, late winter/spring
Risk: all, more severe for infants
Transmission: contact with secretions
23
Q
Human Metapneumovirus Infection
and laboratory
A
Cold like symptoms
Bronchitis or pneumonia
Antiviral: no
Vaccine: no
Molecular, antigen
24
Q
Respiratory Syncytial Virus (RSV) Basics
A
Where: upper and lower respir. tract
What type: enveloped RNA
Geography/season: worldwide, winter
Risk: all, more severe for infants and elderly
Transmission: contact with secretions
25
Respiratory Syncytial Virus (RSV) Infection
| and lab
Most common cause of severe lower respir. tract disease in infants + young children
Cold like symptoms, bronchiolitis, pneumonia
Molecular, antigen POCT, culture
**Antiviral**: no, monoclonal antibody yes
**Vaccine**: for >60 y/o in 2023
26
Mumps Virus Basics
**Where**: upper respir. tract
**What type**: enveloped RNA
**Geography/season**: worldwide, late winter/spring
**Risk**: unvaccinated, immunocompromised
**Transmission**: contact with secretions (droplet)
27
Mumps Virus Infection
| and lab
Asymptomatic to mild, flu-like, **parotitis**
Severe: **inflammation** of testicles, ovaries, pancreas, meningitis, deafness
Molecular, antibody, presentation, culture
**Antiviral**: no
**Vaccine**: MMR vaccine yes
28
Rhinovirus Basics
**Where**: upper resp. tract
**What type**: naked RNA
**Geography/season**: worldwide, early autumn/spring
**Risk**: all, children 2 colds a year, adults 1 cold a year
**Transmission**: contact with secretions
29
Rhinovirus Infection
| and lab
**Most common cause of cold**
>100 serotypes
Asymptomatic to mild
Severe lower resp. disease
Molecular, presentation, culture
**Antivirals**: no
**Vaccine**: no
30
Arbovirus Basics
**Type**: enveloped RNA, CNS
La Crosse, St. Louis Encephalitis, West Nile, Zika
**When:** summertime
**Risk:** outdoors, age, endemic travel
31
La Crosse Virus General
**Type:** arbovirus
**Where:** eastern half of US, wooded areas
**Transmission:** mosquito
**Infection:** mostly asymptomatic, fever
* Severe: encephalitis, comas and siezures, younger than 16 biological risk for severe disease
**Antivirals:** no
**Vaccine:** no
32
St. Louis Encephalitis Virus General
**Type:** arbovirus
**Where:** throughout USA
**Transmission:** mosquito
**Infection:** mostly asymptomatic, fever, headache
* Severe: >60 years old riskier, encephalitis/meningitis, death
**Antivirals:** no
**Vaccine:** no
33
West Nile Virus General
**Type:** arbovirus
**Where:** worldwide
**Transmission:** mosquito, blood transfusion
**Infection:** mostly asymptomatic, West Nile Fever
* Severe: >60 years old, encephalitis
**Antivirals:** no
**Vaccine:** no
34
Zika Virus General
**Type:** arbovirus
**Where:** South America
**Transmission:** Aedes mosquito, congenital, blood transfusion, sexual
**Infection:** mostly asymptomatic, fever, Guillain-Barre syndrome
* Pregnant women: microcephaly newborns, fetal loss, preterm
**Antivirals:** no
**Vaccine:** no
35
Cytomegalovirus Basics
**Type:** enveloped DNA
Herpes family
**Transmission:** body fluid contact, transplants/fusions, congenital
**Risks:** neonates
36
Cytomegalovirus Infection
Life long, reactivation possible
**Mononucleosis**: fever, sore throat
**Congenital**: rash, jaundice, microcephaly, hearing loss common
**Immunocompromised**: pneumonia, failure of organ transplants, retinitis
37
Cytomegalovirus Laboratory
Molecular, antibody
**Antivirals:** yes
**Vaccine:** no
38
Poliovirus Basics
**Type:** enveloped RNA, CNS
Enterovirus family
**Transmission:** fecal oral, resp. secretions
**Risk:** endemic travel
39
Poliovirus Infection
Flu like symptoms
**Severe:** meningitis, paralysis, muscle pain weakness
40
Poliovirus Laboratory
Stool culture, molecular in stool, antibody
**Antivirals:** no
**Vaccine:** yes
41
Echovirus and Parechovirus Basics
**Type:** enveloped RNA
Entervirus family
**Transmission:** respi. secretion
**Risk:** older children, all at risk
42
Echovirus and Parechovirus Infection
| and lab
Flu like if mild
**Severe:** meningitis, rare paralysis
Molecular, antibody, culture
**Antivirals:** no
**Vaccine:** no
43
John Cunningham Virus Basics
**Type:** naked DNA
**Transmission:** urine or respir. secretions
**Where:** worldwide, no seasons
**Risk:** everyone
44
John Cunningham Virus Infection
Lifelong, reactivation possible in immunocompromised
**Progressive multifocal leukoencephalopathy (PML)** damages myelin that covers nerves in brain
AIDS, organ transplants, cancers, immunosuppressed patients at risk
45
John Cunningham Virus Laboratory
Clinical presentation, MRI of brain, molecular CSF, brain biopsy
**Antiviral:** no
**Vaccine:** no
46
Lymphocytic Choriomeningitis Basics
**Type:** enveloped RNA
**Transmission:** rodent salive, urine, feces, aerosols, congenital
**Where:** Europe, Australia, Japan, Americas
**Risk:** neonates, rodent contact
47
Lymphocytic Choriomeningitis Infection
**Biphasic**
Phase 1: flu like
Phase 2: meningitis, rare encephalitis,
**Congenital:** fetal death, birth defects
47
Lymphocytic Choriomeningitis Laboratory
Antibody, molecular
**Antiviral:** no
**Vaccine:** no
48
Rabies Basics and Infection
**Type:** enveloped RNA
**Transmission:** wild animal saliva from bite
**Infection:** prodrome phase with pain and fever, neurologic phase with hallucinations, coordination problems
Then
49
Rabies Laboratory
Molecular, antibody, skin biopsy, Negri bodies
**Antivirals:** no
Post exposure prophylaxis
**Vaccine:** yes
50
Astrovirus Basics
**Type:** naked RNA
**Transmission:** food/water
**Where:** winter and spring
**Risk:** all, elderly and young
51
Astrovirus Infection
| And lab
**Incubation 3-4 days**
Gastroenteritis
**Symptoms last 2-7 days**
Association with meningitis, disseminated
| **Antivirals:** no
**Vaccine:** no
52
Norovirus Basics
**Type:** naked RNA
**Transmission:** food, fecal oral, contact with infected person, leafy greens, fruits, shellfish
**Where:** worldwide, winter, cruise shoops, healthcare places
**Risk:** all, elderly and young
53
Norovirus Infection
| and lab
**Incubation 12-48 hours**
Gastroenteritis
**Symptoms last 2-3 days**
| **Antiviral:** no
**Vaccine:** in the future, no
54
Sapovirus Basics
**Type:** naked RNA
**Transmission:** fecal oral, food, infected person
**Where:** worldwide, winter
**Risk:** everyone, elderly and young
55
Sapovirus Infection
| and lab
**Incubation 12-48 hours**
Gastroenteritis
**Symptoms last 1-2 days**
| **Antivirals:** no
**Vaccine:** no
56
Rotavirus Basics
**Type:** naked RNA
**Transmission:** fecal oral, food water, infected person
**Where:** worldwide, winter and spring
**Risk:** infants
57
Rotavirus Infection
| and lab
**Incubation 2 days**
Gastroenteritis, severe diarrhea and dehydration
**Symptoms last 3-8 days**
Bad for infants
| **Antivirals:** no
**Vaccine:** yes
58
Hepatitis A Basics
**Type**: naked RNA
**Transmission**: fecal oral, sexual, contaminated fruit, shellfish, water
**Geography/season**: worldwide, Africa and Asia, no seasonality
**Risk**: endemic country travel, crowds, needles
59
Hepatitis A Infection
| and lab
Asymptomatic (mostly children)
Incubation average 28 days
**Mild**: fever, fatigue, nausea, dark urine, jaundice
**Severe**: liver failure/death (more common in people with liver disease)
| **Antivirals:** no
**Vaccine:** yes
Post Ex Pro 2 weeks
60
Hepatitis B and D Basics
**Type**: enveloped DNA
**Transmission**: blood contact, transfusion, organ transplant, congenital, sexual
**Geography/season**: worldwide, Africa + Asia (**HBV**), Europe, ME, W+C Africa, E+S Asia (**HDV**), no seasonality
**Risk**: neonate of infected pregnant woman, endemic region travel, many sexual partners, IV drug users, healthcare workers
61
Hepatitis B/D Infection
| and lab
Average 120 day incubation
Acute: 3 wks - 6 months
Fever, fatigue, appetite, dark urine, jaundice, joint pain, vomiting
**Chronic**: slow progressing without symptoms for decades
**Liver cirrhosis or cancer**
**Hep D superinfection:** HDV only comes with or after HBV, rapid progression of symptoms, liver cirrhosis + failure, fulminant hepatitis more likely, more aggressive
| **Antivirals:** yes, for chronic
**Vaccine:** yes
Post Ex Pro
62
Hepatitis C Basics
**Type**: enveloped RNA
**Transmission**: infected blood, transfusion, organ transplant, congenital, sexual
**Geography/season**: worldwide, no seasonality
**Risk**: transplant/transfusion patients, IV drugs, neonate of infected pregnant woman, healthcare workers
63
Hepatitis C Infection
| and lab
4 - 10 week incubation
**Acute**: 2 wks - 3 months
Fever, fatigue, appetite loss, vomiting and pain, dark urine, jaundice, joint pain
**Chronic**: slow progressing, liver failure, cirrhosis or cancer
| **Antivirals:** yes
**Vaccine:** no
64
Hepatitis E Basics
**Type**: naked RNA
**Transmission**: fecal-oral, contaminated water + food, blood transfusion
**Geography/season**: worldwide, E+S Asia, no seasonality
**Risk**: endemic region travel
65
Hepatitis E Infection
| and lab
2-10 week incubation
Mostly asymptomatic
**Mild**: jaundice, dark urine, joint pain, fatigue, fever, vomiting
**Pregnant**: more severe, liver failure, 10-30% mortality
Rare chronic infection
| **Antivirals:** no
**Vaccine:** in china
66
Coxsackievirus A Basics
**Type**: naked RNA
Type of enterovirus
**Transmission**: fecal oral, respiratory secretion (fomites possible)
**Geography/season**: worldwide, autumn + summer
**Risk**: newborns + neonates
67
Coxsackievirus A Infection
| and lab
Asymptomatic to mild, self limiting, like the flu
**Hand-foot-mouth**: fever, sore throat, then painful sores develop in mouth, then skin rash on hands and feet or genital area
| **Antivirals:** no
**Vaccine:** no
68
Herpesvirus 6 and 7 Basics
**Type**: enveloped DNA
**Transmission**: respiratory secretions
**Geography/season**: worldwide, no seasonality
**Risk**: children
69
Herpesvirus 6 and 7 Infection
| and lab
**Life long**, rare reactivation
**Roseola**
High fever, rash on torso, arms, legs, back, and face, can last hours - days
Most people don't get a rash, children do
| **Antivirals:** no
**Vaccine:** no
70
Primate Erythroparvovirus 1 Basics
**Type**: naked DNA (*smallest DNA virus*)
**Transmission**: respiratory secretions, rare congenital
**Geography/season**: worldwide, late winter, spring
**Risk**: fetus of pregnant women, children <15 yo
71
Primate Erythroparvovirus 1 Infection
| and lab
"**Fifth disease**" (erythema infectiosum): slapped cheek appearance
Asymptomatic to mild flu-like
*Rash **after** fever*
Chronic **anemia** patients, aplastic crisis (*invades RBCs*)
**Pregnant women**: risk of fetal loss
| **Antivirals:** no
**Vaccine:** no
72
Measles Morbillivirus Basics
**Type**: enveloped RNA
**Transmission**: respir. secretions, most highly communicable, hard to have herd immunity
**Geography/season**: worldwide, autumn, late winter, early spring
**Risk**: unvaccinated, immunocompromised
73
Measles Infection
| and lab
High fever and rash, **head to trunk**
**Koplik spots on mucous membrane**
**Pneumonia** is most common cause of deaths
Encephalitis
| **Antivirals:** no
**Vaccine:** yes, MMR vaccine
74
Varicella Zoster Basics
**Type**: enveloped DNA
**Transmission**: respir. secretions, *skin vesicle contact*
**Geography/season**: worldwide, no seasonality
**Risk**: non vaccinated, immunocompromised
75
Varicella Zoster Infection
| and herpes, lab
Lifelong
**Chickenpox**
**Herpes**: Shingles, weakened immune system rash
| **Antivirals:** yes
**Vaccine:** yes
76
Orthopoxvirus Basic
**Type**: enveloped DNA
Three types:
- *Smallpox variola major/minor*
- *Vaccinia*
- *M-pox*
Largest most complex virus
**Transmission**: resp. secretion, direct contact with lesion, fomites possible
**Geography/season**: monkeypox in Africa, no seasonality
**Risk**: non vaccinated, immunocompromised, smallpox vaccine adverse effects
77
Smallpox Infection
Variola major (15-40% mortality)
Minor (1% mortality)
1. **Prodrome**: fever, body aches
2. **Rash**: 14 days, most infectious stage
3. **Scabs**: infectious until scabs have fallen off
78
Vaccinia Infection
Used for smallpox vaccine
Live virus
Risks: if you have skin conditions, immunosuppression, pregnant, heart disease
**Necrosis at vacc. site**
**Ocular vaccinia**
**General rash**
**Encephalitis**
Multiple puncture technique
79
M-pox Infection
1. Prodrome: fever, aches
2. Rash: deep lesions that evolve together, can be on **hands and feet**
80
Orthopoxvirus Laboratory
Clinical stages of rash development and spread of rash
Molecular detection
**Antivirals:** for small + mpox*
**Vaccine:** for small + mpox*
81
Smallpox vs. Chickenpox
**SMALLPOX**
Face, arms and legs
**CHICKENPOX**
Face, back and trunk
Develops faster
82
Rubella Virus Basics
**Type**: enveloped RNA
**Transmission**: resp. secretions
**Geography/season**: worldwide, no seasonality
**Risk**: non vaccinated, neonates of susceptible preg women 90% chance of spread
83
Rubella Infection
| and lab
**Rubella** (of the 5 classic rashes)
Rash starts on face, mild symptoms
Miscarriage, congenital defects
**Blindness, deafness**, intellectual problems, heart problems
**Vaccine:** yes, MMR
| **Antivirals:** no
**Vaccine:** yes, MMR
84
BK Polyomavirus Basics
**Type**: naked DNA
**Geography**: worldwide, no seasonality
**Transmission**: urine-oral, fecal-oral, respir. secretions
**Risk**: immunocompromised
**Other**: 90% infected by age 4
85
BK Polyomavirus Infection
| and lab
Lifelong virus, reactivation in immunocompromised
Latent in kidney
Asymptomatic to mild flu like
**Severe**: *cystitis*, loss of kidney transplant
| **Antivirals:** no
**Vaccine:** no
86
Coxsackievirus B Basics
**Type**: naked RNA
Type of enterovirus
**Geography**: worldwide
**Transmission**: fecal-oral, respir. secretions, fomites possible
**Risk**: neonates, immunocompromised
87
Coxsackievirus B Infection
| and lab
Mostly asymptomatic
**Severe**:
*Myopericarditis* beginning with flu like symptoms, chest pain
*Aseptic meningitis*
Pancreatitis, type 1 diabetes
| **Antivirals:** no
**Vaccine:** no
88
Chikungunya Virus Basics
**Type**: enveloped RNA
**Geography**: Afria, Asia, Americas, Caribbean outbreak
**Transmission**: mosquito
**Risk**: endemic travel
89
Chikungunya Virus Infection
| and lab
**Mild**: flu like, severe prolonged joint pain
**Severe**: newborns and elderly at risk
Neurological complications
| **Antivirals:** no
**Vaccine:** no
90
Epstein-Barr Virus (EBV) Basics
**Type**: enveloped DNA
Herpes family
**Geography**: worldwide, no seasonality
**Transmission**: saliva contact, sexual, blood and organ trans.
**Risk**: children and teens
**Other**: 90% of adults have been infected
91
EBV Infection
| and lab
*Lifelong* targets **B lymphs**
Mostly asymptomatic
**Mild**: *infectious mononucleosis* (mono), fatigue, fever, body aches, pharyngitis
**Severe**: Hodgkin's lymphoma, Burkitt's lymphoma, nasopharyngeal carcinoma
| **Antivirals:** no
**Vaccine:** no
92
Ebolavirus Basics
**Type**: enveloped RNA
**Geography**: Africa, no seasonality
**Transmission**: blood or body fluids, spillover event, broken skin or mucous membranes
**Risks**: endemic travel, hospital staff/family members caring for patients, African residents
**Other**: human first infected by animal
93
Ebolavirus Infection
| and lab
**Mild symptoms:** "dry" like flu to "wet" symptoms like diarrhea and vomiting
**Severe**: hemorrhagic fever
Internal + external bleeds, 50% mortality
| **Antivirals:** no
## Footnote
Monocl abs.
**Vaccine**: yes, zaire ebola
94
Lassa Virus Basics
**Type**: enveloped RNA
**Geography**: tropics of Africa, S America, no seasonality
**Transmission**: *rodent* droppings and urine
Person to person through body secretions
**Risks**: endemic travel, rodent reservoirs
**Other**: Guinea, Liberia, Nigeria, Sierra Leone
95
Lassa Virus Infection
| and lab
Mostly mild flu like symptoms
**Severe**: hemorrhaging of gums, eyes, nose
Respiratory distress, vomiting, shock
Neurologic symptoms
**Deafness**
Death from multi organ failure
| **Antivirals:** if given early
## Footnote
**Vaccine:** no
96
Marburg Virus Basics
**Type**: enveloped RNA
**Geography**: Africa, maybe summer and winter due to young bats
**Transmission**: spillover event, blood and body fluids, broken skin, mucous membranes, contact with fomites
**Risks**: cave goers with bats, caretakers of patients
97
Marburg Virus Infection
| and lab
**Mild** symptoms: "dry" like flu to "wet" symptoms like diarrhea and vomiting
*Only contagious when symptomatic*
**Severe**: hemorrhagic fever
Internal + external bleeds, 50% mortality
| **Antivirals:** no
## Footnote
**Vaccine:** no
98
Arbovirus Basics
**Type**: enveloped RNA
**Dengue virus and yellow fever**
**Geography**: mosquito habitats, Africa and S America, summertime, SE Asia
**Transmission**: aedes mosquito, congenital and blood/transplants (dengue only)
**Risks**: endemic area, outdoors, blood transfusions
**Other**:
Dengue: human reservoir
Yellow fever: monkey reservoir
99
Yellow Fever Infection
| No antiviral
## Footnote
Vaccine: yes limited
Flu like with back pain, nausea
Weakness and fatigue prolonged
**Severe**: sometimes after brief remission
High fever, jaundice, bleeding, organ failure
30-60% mortality
100
Dengue Virus Infection
Asymptomatic to mild
Flu like with bone and joint pain (**break bone fever**), sometimes *rash or eye pain*
**Severe**: shock, internal bleeding and death after fever
Risk increases if previously exposed to Dengue
| Antiviral: no
## Footnote
Vaccine: yes limited
101
102
Herpes Simplex 1 + 2 Basics
**Type**: enveloped DNA
**Transmission**: direct contact w/ secretions
1: transmitted orally
2: transmitted sexually
**Geo**: worldwide, no season
**Risk**: sexually active ppl, children, immunocompromised
103
Herpes Simplex Virus Infection
| and lab
Lifelong, reactivation possible
Asymptomatic, HSV-1 common in childhood, never detected
**Mild**: flu like, cold sores, fever blisters, genital lesions, *herpetic whitlow*
**Severe**: disseminated disease in immunocompromised and neonates, *encephalitis (HSV-1 mostly), meningitis (HSV-2 mostly)*
| **Antivirals**: yes, shortens illness
## Footnote
**Vaccine:** no
104
Genital Herpes
Painful
Most common ulcerative STD
**HSV simplex 2**
No cure
12% of USA has HSV-2
More common in women due to male to female transmission vs. male to female transmission
105
HIV 1 + 2 Basics
**Type**: enveloped RNA
**Transmission**: sexual contact, blood exposure, organ transplant, perinatal exposure
**Geo**: worldwide, no season
**Risk**: needle drug use, sexually active, newborns of HIV mothers, blood/organ recipients before 1985
106
HIV 1 + 2 Infection
| and lab
Lifelong
**Affects CD4/T cells**
**Acute**: 2-4 weeks flu, immune response stabilizes infection
Clinical **latency**: asymptomatic/chronic, HIV still active, reproduces at low levels
Lasts up to a decade
Antiretroviral therapy = longer clinical latency
| **Antivirals:** yes
Pre Ex Pro
## Footnote
**Vaccine:** no
107
HIV/AIDS Infection
*AIDS*: acquired immune deficiency
CD4 < 200 cells per mm^3
Reference range: 500-1600
Vulnerable to infections, cancers
Life expectancy without treatment: 3 years, opportunistic: 1 year
108
Human T-Cell Lymphocytic Virus HTLV Basics
**Type**: enveloped RNA
**Transmission**: sexual, blood, organ, breastfeeding
**Geo**: endemic Japan, C + W Africa, Caribbean, S America, no season
**Risk**: vein drug user, sex, newborns of positive mothers, Native American
**Other**: most common through drug users in USA
109
HTLV Infection
| and lab
Lifelong
Mostly asymptomatic
Symptoms very late 20-30 years after infection
Adult acute T leukemia/lymphoma
Neurologic disease: weakness in legs, backache, more in women
| Antiviral: no
## Footnote
Vaccine: no
110
Human Papillomavirus HPV Basics
**Type**: naked DNA
**Transmission**: direct or sexual contact
**Geo**: worldwide, no season
**Risk**: sex
**Other**: most common STI, more than 200 subtypes
111
HPV Infection
| and lab
Mostly asymptomatic
Can lead to cervical cancer
Nongenital **cutaneous**: benign *plantar warts*
**Mucosal**: squamos cell carcinoma of lung, laryngeal carcinoma, respiratory papillomatosis
**Anogenital**: genital warts, carcinoma of reproductive area
| Antivirals: no
## Footnote
Vaccine: yes
