week 3 day 3: Hep and MMR Flashcards
What are the funny names for Measles Mumps and Rubella?
Measles = Rubeola
• Mumps
• Rubella = German Measles = 3-Day Measles
When is Measles transmissible?
“window” - 4-5 days before the rash happens and is extremely infections, even without symptoms
What are Measles symptoms?
- Initial: Cough, Coryza (Runny nose), Conjunctivitis
- Koplik’s Spots -white/blue/grey spots on erythematous base, buccal mucosa
- Rash Sandpaper -Starts at the head and moves down. May desquamate
What are measles tx? Prevention?
no tx, only vaccine 99% efficacy with 2 doses, 97% efficacy with one
4 main complications of measles?
Transient immunosuppression
Bacterial Superinfection
Encephalitis
Subacute Sclerosing Panencephalitis (SSPE; Dawson Disease) - alway fatal
What are the clinical manifestations of Mumps?
Parotitis 50-70% - major!
Orchitis 10-20% of men
Meningitis 10%
No rash (unlike measles)
3 common things between measles, mumps and rubella?
-shedding window before the symptoms arise → contageous!!
No TX
Vaccine highly effective
Clinical Manifestations of rubella?
Congenital Infection: “blueberry muffin rash”, inflammation of the eyes, birth defects small eyes, brain (developmental delays), cardiac abnormalities
children and adults: Asymptomatic, rash starting at the head and moving down
What is the concerned population for rubella?
pregnant women
example of infection where herd immunity really works?
MMR
What are the two Hep viruses that are transmitted fecal-orally?
Hep A, Hep E
What are the two Hep viruses that do not have a chronic state?
Hep A and Hep E
What are the prevention strategy for HepA? Tx?
Vaccination (travelers to endemic areas, chronic liver disease)
Post exposure prophylaxis Vaccination for 1-40yr and Immunoglobulin for >41yr
and sanitation (contaminated food, water or hands)
No tx, supportive care
Incubation period for HepA? Why is it significant?
28 days! Even without symptoms people shed the virus for several weeks and continue shedding 1 week after the symptoms resolve
is protection agains HepA (HAV) lifelong?
Yes! IgG anti HAV confers lifelong protection
Fist Antibody to arrive to HAV infection?
IgM - 5 days before symptoms
What is the leading cause of viral Hepatitis in developing countries?
Primary risk?
HEV
Contaminated water.
What are the high risk categories of people for HBV?
IV drug users, Healthcare workers, high risk sex
Incubation period for HBV?
1-6 months, because non-cytolytic, large window of infectious period (person asymptomatic) !!
What are the 4 diagnostic findings of acute stage in HBV? What does each indicate?
- Serum HBsAg - surface antigen - 1st thing to test for HepB-once you make Ab against surface antigen you are protected for Life
- HBeAB - Non-protective but indicates lower infectivity
- Core HBcAB - non-protective persists for life
- HBsAB-protective immunity (resolved infection or vaccination)
What are the three diagnostic findings fir a resolved HBV infection?
- Normal Liver function test
- HBV DNA negative
- HBsAG negative
- HBsAB positive
- HBcAB positive
What are the diagnostic findings of chronic HBV infection?
Main difference with resolved is that chronic doesn’t make antibodies against surface antigen (No HBsAB)
How does HDV infect the host? What are the two options?
needs HBV. So HDV is only possible with the initial infection of HBV.
- Co-infection: HBV+HDV, HBsAB protective for both
- Superinfection: HDV is acquired later and it leads to severe hepatitis
What is the most chronic blood-born infection in the US?
HCV
What Are the risk factors for HepC transmission in US?
IV drug users, Sexual transmission
What are the two hep viruses which are non-cytolytic?
HCV, HBV
What are the two health problems of chronic HCV?
Cirrhosis and hepatocellular carcinoma
Are AB to Hep C confer immunity?
NO
What percentage of people are asymptomatic for HepC?
60-80% with chronic Hep C are Asymptomatic,
80% of HEP C become chronic
25% get cirrhosis, 5% of HCC
once symptoms began, there Is already damage to liver
What is HBV transmission?
Blood, perinatal, sexual
What ar e the most likely ways of HepC transmission?
Blood>sexual>perinatal
HepD transmission?
Blood, perinatal, sexual
What are the only three Hep viruses witch a chronic state?
HepB, HepC, HepD
What are the prevention strategies for HepB?
Vaccination
Prevention strategies for HepC?
Screen blood products, risk reduction
Prevention strategies for HepD?
Vaccination against HBV!
Prevention strategies for HepE?
Sanitation
Which hep virus doesn’t have any vaccine?
Hep E and Hep C
