Zoonotic Viral Diseases I/II

Question 1

This deck will cover all the new zoonotic viruses that weren’t already covered in another deck.

Answer 1

Carry on

Question 2

Let’s start with rabies. Describe the structure

Answer 2

-ssRNA, enveloped, bullet-shaped, helical nuclear capsid

Question 3

Who carries rabies around?

Answer 3

1. bats
2. raccoons
3. skunks
4. foxes
5. coyotes

Question 4

Describe the pathophys of rabies virus?

Answer 4

Virus contains glycoprotein which binds to nicotinic acetylcholine receptors on postsynaptic membrane of NMJ.
Virus travels retrograde via peripheral nerves to dorsal root ganglia; affects pyramidal cells of hippocampus and Purkinje cells

Question 5

What sx will you get with rabies?

Answer 5

salivation, dysphagia (spasms in muscles of larynx/throat), muscle spasms, fever, acute encephalitis, uniformly fatal (untreated) with incubation of weeks/ months`

Question 6

Dx of rabies???

Answer 6

dFA of brain (direct fluorescence antibody stain).

Question 7

What will you see on Histo for rabies?

Answer 7

Negri bodies=eosinophilic cytoplasmic inclusion bodies (in pyramidal cells of hippocampus and purkinje cells)

Question 8

What do you do when you get bit by a bat and you’re like OMG I’M GONNA GET THE RABIES WHATDOIDOWHATDOITDOWHATDOIDO

Answer 8

after bite in someone who was never vaccinated→ post-exposure anti-rabies vaccine and passive antibody (HRIG)

Question 9

What is the structure of Coronavirus?

Answer 9

+ssRNA, helical capsule

Question 10

What are the sx of Coronavirus?

Answer 10

Can cause:

1. acute bronchitis that leads to ARDS, 2. common cold
2. SARS

Question 11

Source of coronavirus

Answer 11

bats and other animals (civet) in Asian game market

Question 12

What is MERS-CoV?

Answer 12

MERS-CoV: Middle East respiratory syndrome coronavirus. Likely from camels, carried by bats

Question 13

How do you dx coronavirus?

Answer 13

antibodies to SAR confirmed with PCR

Question 14

Tx for coronavirus?

Answer 14

1. broad spectrum antibiotics
2. ribavarin
3. corticosteroids

Question 15

Where will you get Hendra virus?

Answer 15

flying fox bat, horses in Australia

Question 16

Where will you get Nipah virus?

Answer 16

Bat, pigs in Malaysia

Question 17

What kind of viruses are Hendra and Nipah virus?

Answer 17

Paramyxoviruses

Question 18

What can Nipah/Hendra virus cause?

Answer 18

Multisystemic vasculitis→ thrombosis, ischemia, and necrosis. Can lead to disease of brain (acute encephalitis), lung (pneumonitis) and spleen.

Question 19

Structure of Hantavirus? Genome?

Answer 19

-ssRNA, enveloped

Genome contains 3 RNA segments: L, M, S

Question 20

How is Hantavirus transmitted?

Answer 20

Inhalation of infected rodent excrement or direct contact through skin

Question 21

What does Hantavirus cause?

Answer 21

HFRS (hemorrhagic fever w/ renal syndrome) aka hantavirus disease =fever, HA, hemorrhage, acute renal failure.

Question 22

What can Sin Nombre virus cause?

Answer 22

HA, back/abd pain, fever, chills, nausea, blurred vision, HFRS, HPS (Hanta pulmonary syndrome**this syndrome is mostly caused by Sin Nombre virus, despite the name)

Question 23

How is Sin Nombre virus transmitted?

Answer 23

Inhalation exposure in the Four Corners region of US

Question 24

Tx for Sin Nombre?

Answer 24

Supportive

Question 25

What kind of virus is Sin Nombre virus?

Answer 25

Bunyavirus

Question 26

Strucutre of Flavivirus?

Answer 26

+ssRNA, enveloped, non-segmented

Question 27

Tell me some things about Japanese encephalitis (Caused by flavivirus) 1. Transmission 2. Dx? 3. Tx?

Answer 27

1. transmission involves culex mosquitoes, birds and pigs 2. Dx: serology 3. Tx: NONE WAH

Question 28

Are most infections by Japanese encephalitis super duper bad like you're gonna die today kind of bad?

Answer 28

No. No, it's actually usually subclinical. Relax, kid.

Question 29

There are two kinds of Yellow Fever (caused by flavivirus). Tell me about them.

Answer 29

1. Jungle form: natural reservoir of dz, cycle in non-human primates and forest mosquitoes. Humans incidentally infected when in jungle. 2. Urban form: transmitted between humans by Aedes aegypti mosquito.

Question 30

What are the sx of Yellow Fever?

Answer 30

1. chills 2. HA 3. f/n/v 4. “Black vomit” and liver dz→ jaundice 5. blood diarrhea 6. backache

Question 31

Dx, Tx, and vaccine for Yellow Fever?

Answer 31

Dx: serology Tx: none. wah. Vaccine: live attenuated

Question 32

Where are you most likely to get Yellow Fever?

Answer 32

W. Africa | S. America

Question 33

Where are you most likely to get Dengue fever?

Answer 33

SE Asia Africa Caribbean S. America

Question 34

What are the sx of dengue fever?

Answer 34

1. “break bone fever” 2. lymphadenopathy 3. myalgia 4. bone/joint pains 5. headache (retro orbital) 6. maculopapular rash.

Question 35

What can happen to people previously infected with a different Dengue serotype?

Answer 35

1. hemorrhagic fever 2. renal failure 3. septic shock

Question 36

How many serotypes of Dengue are there? What's special about type 2?

Answer 36

4 types | type 2 affects the bone marrow -> thrombocytopenia->spontaneous bleeding.

Question 37

Dx and Tx of Dengue fever?

Answer 37

Dx: serology Tx: Supportive

Question 38

What's the reservoir and vector for West Nile virus?

Answer 38

``` reservoir = birds vector = culex mosquito ```

Question 39

What are the lovely sx of West Nile virus?

Answer 39

myelitis → flaccid paralysis, seizures and coma; encephalitis

Question 40

Tx for West Nile virus?

Answer 40

supportive

Question 41

Structure of togavirus?

Answer 41

+ssRNA, enveloped

Question 42

What sx do you see with togavirus?

Answer 42

Flu-like sx→ encephalitis 3-10 days post infection. Generally self-limited. Possible paralysis, mental disorders, death

Question 43

Transmission of togavirus?

Answer 43

Reservoir=Horse | Vector=mosquito

Question 44

Tell me about EEE?

Answer 44

``` found in Eastern U.S. Rarest. Mostly asymptomatic or nonspecific fever. Neuro involvement seen in 1 in 23. 30% fatality. ```

Question 45

Tell me about WEE?

Answer 45

Found in Western U.S. More frequent. Neuro involvement seen in 1 in 1000 adults, 1 in 25 infants (may cause permanent brain damage in infants) 60% of survivors have neuro impairment.

Question 46

Tell me about VEE?

Answer 46

Found in Central and S. America; incompletely understood. Sx=acute fever 2-6 days post infection with major systemic sx Neuro involvement less common and less severe than EEE/WEE.

Question 47

Is there a treatment for togavirus causing EEE, VEE or WEE?

Answer 47

NO

Question 48

Structure of Reovirus?

Answer 48

****dsRNA, 9-12 segments, non-enveloped, icosahedral

Question 49

Two reoviruses you should know

Answer 49

1. Rotavirus | 2. Colorado tick virus

Question 50

What are the sx of rotavirus? Who is most at risk?

Answer 50

#1 cause of watery diarrhea in kids

Question 51

What toxin mediated the watery diarrhea in rotavirus?

Answer 51

NSP4 toxin which increases chloride permeability

Question 52

Transmission of rotavirus?

Answer 52

fecal-oral transmission

Question 53

What are the sx of Colorado Tick virus?

Answer 53

Colorado tick fever→ generally mild or subclinical. Acute dz resembles dengue→ fever, chills, HA, myalgia, arthralgia, photophobia, lethargy. Found in Rocky Mountain states; differentiated from RMSF because no rash.

Question 54

Transmission of Colorado Tick Virus?

Answer 54

``` Wood tick Many reservoirs (squirrels, rabbits, deers) ```

Question 55

Tx for rotavirus?

Answer 55

Oral rehydration

Question 56

Vaccine for rotavirus?

Answer 56

Oral, live attenuated (give before 3 months age). Increases risk of intussusception due to enlargement of Peyer’s patches